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A Dietary Study 



OF SOME KANSAS INSTITUTIONS 
UNDER CONTROL OF THE STATE 
BOARD OF ADMINISTRATION 




By E. H. S. BAILEY 

Professor of Chemistry , University of Kansas 
Chemist, State Board of Health 



PRINTED BY KANSAS STATE PRINTING PLANT 

B. P. WALKER, State Printer 

TOPEKA 19 31 

9-575 



A Dietary Study 



OF 



SOME KANSAS INSTITUTIONS UNDER THE 

CONTROL OF THE STATE BOARD 

OF ADMINISTRATION 




BY 

E. H. S. BAILEY 

I'tofessor of Chemistry, University of Kansas 
Chemist, State Board of Health 



IJ'.VIFI) BY KANS\S STATU I'RIN' N i PLANT 

B i*. \v\i,h ku. statu I'uimtkh 

TOl'EKA 11121 

!l 575 



LE^i'ER OF TRANSMITTAL. 



Lawrence, Kan., September 1, 1921. 
To the State Board of Administration: 

Gentlemen — In accordance with your request, I am trans- 
muting herewith the abstract of my report on the dietaries of 
some of the state institutions under the control of your board. 
Respectfully, E. H. S. Bailey. 

(4) 



A Dietary Study of Some Kansas Institutions. 

By E. H. S. Bailey. 



INTRODUCTORY. 

The importance of dietary studies has only been recognized for the 
past seventy-five years. The people of the United States have been re- 
garded as generous feeders, as we grow all the food that we really need 
and have an excess to export to the nations abroad. The question as to 
the food of the individual becomes more complicated when applied to 
large groups of people, as to boarding schools, reformatories, orphanages 
and hospitals. Questions as to the quality, the quantity and the cost of 
foods furnished to such large units of people are constantly arising. 

In order to study this understandingly we must first consider how 
food nourishes and sustains the body. The food is used in two ways: 
First, to build up and repair body tissue; and second, to furnish the 
body with the energy required to maintain vital processes and for 
muscular work. We are familiar in general with the fact that the pro- 
tein or nitrogenous foods, such as meat, milk and eggs, are needed to 
build up the tissues, and that fats, or butter and oil, and carbohydrates, 
such as cereals and sugar, are needed to furnish the energy for work. 

It is only within a comparatively few years that we have been able 
to measure dietaries in a scientific manner. Following the European 
chemists, Prof. W. O. Atwater was a pioneer in this country in making 
food investigations, and constructed what was called a respiration 
calorimeter, which was a large box in which an experimenter could re- 
main for several days, all food used could be weighed, and all the prod- 
ucts of the digestion and respiration could be analyzed. The work dor.e, 
or mechanical energy produced by the food eaten, could also be ac- 
curately measured. 

It has also been ascertained that if food is burned in a bomb calori- 
meter in the laboratory, the amount of heat evolved corresponds very 
closely to the heat or energy produced by the digestion of the food in the 
boiy. The analysis of a food tells us the calories of heat or energy, 
for it is established that — 

One pound of protein gives 1,860 calories. 

One pound of fat gives 4,220 calories. 

One pound of carbohydrates gives 1,860 calories. 

A calorie is the amount of heat that is required to raise the tempera- 
ture of one kilogram of water from 0° to 1°C. This explanation is neces- 
sary that the data shown in the tables following may be intelligible. 

There are two general methods of studying the amount of food needed 
for an individual. The first is to ascertain accurately how much food of 
each kind is consumed by a family, a club or an institution in a given 
time — say a month — then to find the food value of this total amount of 

(5) 



6 A Dietary Studij. 

food, and from this data to get the amount per day per capita. In this 
method we consider the food under ordinary conditions of feeding, where 
no attempt is made tc limit the diet. 

The second method is to have "feeding squads" to whom determined 
amounts of food are given; here the diet can be regulated and different 
proportions of the nutrients given, and the waste matter, or "products 
of the metabolism," can be studied. 

The former method, or a study of the food under normal conditions, 
has been used in the work on Kansas institutions. The chemistry de- 
partment of the University, at the request of the state auditor's office, 
made some dietetic studies of the food used at the State Penitentiary, 
and these results are published in a report of the auditor under date of 
March 17, 1916. At the request of the State Board of Administration, 
the chemistry department has more recently made a study of other in- 
stitutions under the care of the Board. 

Some of the objects of this investigation were to find out as far as 
possible: 

First: Whether the quantity of food used is sufficient for the inmates. 
Second: Is the quality satisfactory? 

Third: Are the different nutritives so distributed that there is a suffi- 
cient proportional quantity of carbohydrates, fats and proteins? 

Fourth : Is it possible to substitute cheaper foods for those issued and 
still keep up the proper dietary? 

Fifth : Could any other foods be added to the menu with advantage 
to the inmates? 

Sixth: Is there any unnecessary waste in preparing, dispensing or 
serving the food? 

Seventh: Are all the waste products utilized as far as possible by 
feeding to animals and in similar ways? 

Eighth: Can the variety of food be increased without additional ex- 
pense? 

With these objects in view, the steward has been asked to furnish the 
quantity of each kind of food issued per month, and this investigation 
has been carried through for four or six months, or in some cases for an 
entire year, which would cover both the summer and winter dietary. 

The results given in the following tables have been compiled from the 
steward's report, and following the tables is a discussion of the results, 
with suggestions as to any possible improvements that might be made. 

As in most of these institutions the steward issues the needed foods 
daily to the different kitchens (at the Penitentiary there are four), an 
accurate account is kept of the daily population, or those who use this 
food, and from this data, at the end of the month, we have what the 
inmates have lived on for that month. In most of these kitchens the 
waste is fed to hogs, so that the actual loss of food material is small. 
The fruits, vegetables, etc., raised on the institution farm are accounted 
for, and issued to the inmates as if purchased at market price. This 
practice, of course, greatly lowers the actual cost to the state of keeping 
the inmates of these institutions. 



Introductory. 7 

There are in the state of Kansas the following' institutions which 
provide shelter, food and clothing for the inmates: 
Educational institutions: 

1. School for Deaf, Olathe. 

2. School for Blind, Kansas City. 
Charitable institutions: 

3. Topeka State Hospital. 

4. Osawatomie State Hospital. 

5. Parsons State Hospital for Epileptics. 

6. State Training School, Winfield. 

7. State Hospital, Larned. 

8. State Orphans' Home, Atchison. 

9. State Hospital for Tuberculosis, Norton. 
Correctional institutions: 

10. Penitentiary,' Lansing. 

11. Industrial Reformatory for Young Men, Hutchinson. 

12. Industrial School for Boys, Topeka. 

13. Industrial School for Girls, Beloit. 

14. Industrial Farm for Women, Lansing. 

The reports made on these institutions cover different periods of time, 
beginning in 1916. From the steward's report a table is made, giving the 
names of food materials, quantity; and, in pounds, .the weight of pro- 
teins, fat, and carbohydrates; and finally, the total calories for that food. 
The calories are calculated according to a well-known method from the 
table of food analysis which is published by the United States Department 
of Agriculture, or the Laboratory Manual of Dietetics, by Dr. M. S. Rose. 
Figures in the column labeled "calories" show that the most of the energy 
from the food comes from bread, beef, butterine, beans, flour, lard, corn 
meal, milk, potatoes, rice and syrup. There is a great variety in the 
food, as shown in some cases by the tabulation of the varieties of food 
furnished for each month. 

In the condensed reports of the different institutions which follow, a 
complete list of foods used for a single month, taken at random, is given, 
and this is followed by tables based on the study of the entire period. 
As this comparison of dietaries was made at different periods, partly 
during the war, it is not possible to compare too critically the institu- 
tions the one with the other, either with reference to costs or variety of 
foods served. 



L 

KANSAS STATE PENITENTIARY. 

(Abstract of Report.) 



Lawrence, Kan., March 11, 1918. 
Following is an abstract from the report on the food and dietary fur- 
nished at the State Penitentiary at Lansing. 

QUALITY OF FOODS. 

The stores examined were of good quality. A few special samples of 
foods were obtained for examination in the laboratory of the State Uni- 
versity, and those showed that the quality was good, with no indication 
of adulteration. 

FOOD SUPPLIED FOR EACH OF SIX MONTHS OF 1917. 

The food is given out daily from the storeroom to the four kitchens — 
main, female ward, hospital, and insane — on requisitions. From these 
figures of the storekeeper we have obtained the amount issued to each 
kitchen for the six months beginning July 1, 1917. The total amount of 
each food for each of the above months, with the number of pounds of 
protein, fat and carbohydrates, and the calories or units of energy of 
each, and the sum for the month, are given in the accompanying tables. 
The detailed report for the single month of September is shown herewith. 

(8) 



Kansas State Penitentiary . 

KANSAS STATE PENITENTIARY. 
TABLE A. — Dietary of all four kitchens for September, 1918. 



Articles of Food. 



Apples, green. . . 
Apples, dried. . . 
Baking powder. 
Beans, Mexican. 
Beans, white. . . . 
Beans , Lima. . . . 
Beans, green. . . . 

Beef, fresh 

Beets 

Butterine 

Carrots 



Cheese . 

Corn, green 

Corn flakes 

Crackers, cream. 
Crackers, soda . . 

Cucumbers 

Ducks 



Flour 

I/rd 

Meal, corn 

Meal, oat 

Milk 

Onions 

Oysters 

Peaches 

Peaches, dried 

Pears 

Pickles 

Pork, fresh 

Pork, salt 

Potatoes, Irish . . . 
Potatoes, sweet. . . 

Prunes 

Radishes 

Raisins 

Raspberries 

Rice 

Sardines 

Sausage, bologna. 
Sugar, brown .... 
Sugar, granulated. 

Sausage, pork 

Susage, Vienna 

Squash 

Tomatoes 

Yeast 



Totals 167,2250.5 



Pounds. 



232.00 

150.00 

150.00 

100.00 

100.00 

560.00 

1135.00 

484.00 

,550.00 

,320.00 

525.00 

,650.00 

197.00 

714.00 

78.00 

347.50 

198.30 

,183.00 

316.00 

228.00 

,S62.00 

,800.00 

600.00 

630.00 

,400.00 

,425.00 

15.00 

22.50 

900.00 

56.25 

50.00 

,125.00 

,339.00 

,880.00 

,875.00 

200.00 

290.00 

250.00 

28.50 

500.00 

24.00 

.003.00 

300.00 

200.00 

200.00 

706.00 

500.00 

026.00 

200.00 



Protein, 
pounds. 



24.69 
2.40 



240.90 

247.50 

103.36 

61.63 

2,825.18 

20.15 

15.84 

4.72 

65.10 

49.64 

8.56 

4.29 

33.90 

19.43 

36.28 

48.66 

27.13 

2,000.54 



55.20 

101.43 

673.20 

47.95 

1.32 

.15 

42.30 

.16 

.25 

234.37 

315.00 

411.84 

26.25 

3.60 

2.61 

8.05 

.22 

4'00 

5.68 

182.54 



286.00 
757.68 

10.50 
270.23 

23.40 



Fat, 

pounds. 



24.69 
3.30 



14.30 

19.80 

8.40 

8.80 

3,273.31 

1.55 

1,095.60 

1.05 

9.30 

66.38 

2.85 

1.17 

42.28 

18.04 

10.36 

50 56 

21.20 

178.62 

1,800.00 

11.40 

45.36 

816.00 

10.27 

.36 

.02 

9.00 

.16 

.15 

1,712.50 

4,214.83 

22.88 

11.25 



.29 

10.50 

.59 

1.50 

2.90 

197.59 



968.00 

598.02 

3.00 

120.10 

.80 



15,409.03 



Carbo- 
hydrates, 
pounds. 



889.05 
99.15 
67.50 
716.10 
655.60 
369.04 
202.51 



119.35 



38.85 

223.20 

4.72 

54.97 

63.18 

343 . 60 

144.95 

134.75 



13,378.63 



452 40 

425.25 

1,020.00 

339.07 

.58 

2.43 

562.50 

10.12 

1.35 



,363.36 
410.62 
124.40 

11.60 
239.75 

16.07 
395.00 



285.00 
5,200 00 
24.20 
165.06 
67.50 
1,171.01 
42.00 



31,834.42 



Calories. 



1,761,648 
197.700 



122 

1,842 

1,720 

888 

516 

19,094 

258 

4,501 

83 

560 

384 

127 

127 

676 

371 

352 

293 

135 

28,632 

7,347 

967 

1,140 

6,405 

681 

5 

4 

1,134 

19 



7,671 
18,339 
6,955 



232 

26 

492 

32 

795 

22 

1,137 

517 

9,432 

4,514 

4,018 

154 

3,092 

122 



101) 

500 

400 
11,1) 
560 
320 
850 
.'iio 
475 
790 
150 
092 
218 
282 
812 
444 
880 
660 
786 
600 
800 
310 
600 
575 
025 
792 
000 
550 
500 
875 
465 
520 
125 
300 
970 
450 
775 
500 
176 
402 
200 
800 
400 
410 
500 
678 
000 



138,755,625 



10 



A Dietary Study. 



In addition to the report on all four kitchens, and as a check for com- 
parison of the amounts of food used, a study is also made of the dietary 
for the months of October and December for the main kitchen and the 
female ward. The details of these are not given in the abstract. 

KANSAS STATE PENITENTIARY. 
TABLE B.— Summary for all four kitchens and of main kitchen and female ward. — Per capita use of food. 



Dietaries. 



July 

August. . . . 
September. 
October. . . 
November. 
December . 



Average . 



Weight 

of 
foods, 
pounds. 



5.57 
7.55 

6.92 
5.65 
5.58 
4.88 



5.93 



Protein. 



Pounds. Grams 



0.36 
.35 
.38 
.28 
.35 
.30 



0.32 



163.29 
158.76 
174.36 
127.00 
158.22 
136.54 



147.60 



Fat. 



Pounds. Grams 



0.56 
.51 
.63 
.38 
.57 
.39 



0.49 



254.01 
231.33 

285.76 
173.36 

258.55 
176.90 



223 18 



Carbohydrates. 



Pounds. Grams 



1 45 
1.60 
1.39 
1.59 
1.46 
1.42 



1.48 



657.72 
725.76 
630.50 
721.22 

662.25 
644.11 



673 59 



Calories. 



5,441 
5,821 
5,748 
5,332 
5,734 
4,799 



5.389 



COMPARISON OF SINGLE KITCHENS. 



Main kitchen, October .... 
Female kitchen, October . . . 
Main kitchen, December. . 
Female kitchen, December. 



1 

5.63 


0.33 


152.40 


44 


199.58 


1.60 


725.75 


4.93 


.25 


113.40 


.27 


122.47 


1.38 


625.96 


4.77 


.27 


124.47 


.38 


172 35 


1.39 


630.50 


1 3.72 


.21 


96.25 


2 


104.32 


1.00 


453.60 



5,383 
4,049 
4,557 
3,441 



KANSAS STATE PENITENTIARY. 
TABLE C. — Comparison of per capita use of some of the important staj les ;.t Lansing, for all four kitchens for 

each of six months, 1917. 



Staples. 


July, 
ounces. 


August, 
ounces. 


September, 
ounces. 


October, 
ounces. 


November, 
ounces. 


December, 
ounces. 




10.56 

.50 

10.72 


12.96 

.32 

13.44 


11.84 

.32 

15.04 

1.12 

1.76 

1.60 


12.64 
1.44 

11.84 
8.48 
1.44 
4.80 
2.08 
9.28 
1.76 
1.28 
4.48 
.64 

10 24 


10.24 
1.12 

14.88 
9.12 
1.60 
1.76 
4.12 

11.52 
4.48 
1.00 
4.48 
1.00 
8.00 


12 80 


Hominy and corn meal. . 
Potatoes, Irish 


1.00 
15.04 

4.12 


Beans and peas, dry 

Sugar 

Sirup 


1.92 
2.56 
3.84 
8.48 
5.60 

.80 
4.64 

.50 
16.48 


1.44 

2.40 
4.64 
8.80 
3.84 
1.00 
3.84 
.64 
15.52 


1 44 
1.76 
3.04 


Beef 

Pork, fresh and salt 

Lard 

Sausage, four varieties. . . 

Butterine 

Milk 


12.80 

5.60 

1.12 

3.84 

.80 

13 11 


7.68 
1.44 
1 .12 
2.88 
1.00 
7.68 







DISCUSSION OF RESULTS. 

Considering the "fuel value" or calories furnished by the food sup- 
plied, and the amount of protein per capita for each of the six months, 
it will be noted that the range of calories for the six months considered 
is from 4,799 to 5,821, with an average of 5,389. The female kitchen for 
October and December 4s 4,049 and 3,441. It is estimated that women 
need one-fifth less food than men. A recent authority, Doctor Davis, in 
Food in Health and Disease, quotes the following dietary standards for 
the United States: 

Grams protein. Calories. 

Women with light muscular work 90 2,400 

Women with moderate muscular work 100 2,700 

Men without muscular work 100 2,700 

Men with light muscular work 112 3,000 

Men with moderate muscular work 125 3,500 

Men with hard muscular work 150 4,500 



Kansas State Penitentiary. 11 

Doctor Langworthy, of the United States Department of Agriculture, 
gives similar figures for men only, which range from 2,450 without mus- 
cular work to 5,500 for very hard muscular work. 

Considering the number of inmates fed one day during the six months 
at the Lansing Penitentiary, which is 144,975: 31,104, or 21.5 per cent, 
are in the female, insane and hospital kitchens and would not need the 
greatest quantity of food; of the remaining 78.5 per cent, many are en- 
gaged in light muscular work. It would seem then that an average of not 
over 3,500 calories ought to be sufficient for the inmates of this institu- 
tion. The figures show that there is an excess of 1,800 calories per day 
per capita. 

In regard to the amount of protein used, the proportion between that 
and the other food is fairly well maintained. There is, however, too 
much protein used, the average for the six months being 153 grams per 
day per capita, while 120 grams should be sufficient. There should be 
a decrease in the total food issued which would bring the protein down 
to nearer the required amount, and the proportion of carbohydrates 
(bread, sugar, syrup) and of fats (pork and sausages) might be still 
further reduced. 

DIETARY TABLE, PER CAPITA. 

Attention is further called to the nutritive ratio of dietaries per capita 
for each month, as shown in table B. This shows the actual weight of 
food used by each inmate, and of what it consisted. There is an appreci- 
able decrease in the weight of the food for December, which is also shown 
by the calories consumed. The number of grams of protein consumed for 
each month is also given, which can be compared with the 120 grams 
assumed to be sufficient. There is a notable diminution in the number 
of calories and in the weight of the food for December. This may be 
due partly to the use of less sugar. 

PER CAPITA USE OF STAPLE FOODS. 

Referring to table C, a comparison is made of the staple foods used 
for each month, both in decimals of a pound, and, for convenience, in 
ounces. 

Flour ranges from 10.24 to 12.96 ounces. This amount would give a 
little more than a pound of bread for each person. Corn meal and corn 
products should replace to a greater extent the wheat products. 

Sweet potatoes evidently when served do not take the place of Irish 
potatoes, as might be the case, but are served in addition to the Irish 
potatoes. 

In regard to sugar and sirup, the United States, before the war, used 
of sugar 3.95 ounces per capita. 

Per capita. 

Hoover's estimate of amount necessary 1.58 ounces 

France uses 57 ounces. 

England uses 1.14. ounces. 

Italy uses 39 ounces. 

The figures shown above for the Kansas Penitentiary show the use of 
2.5 ounces, with an addition of 3.5 ounces in the sirup, thus making 6 
ounces all together. 

The amount of beef varies from 8.48 ounces to 12.8 ounces, but to this, 
for animal food, must be added the pork, lard and sausages. 



July. 


Aug. 


Sept. 


Oct. 


Nov. 


Dec. 


26.53 


26.07 


23.75 


29.79 


22.50 


32.62 


9.60 


13.46 


13.76 


13.51 


13.34 


12.75 


3.39 


2.12 


2.78 


1.97 


2.93 


3.54 


13.60 


14.07 


8.53 


14.78 


11.63 


11.70 


3.50 


7.30 


7.17 


9.73 


8.32 


11.17 


6.91 


5.74 


4.99 


4.00 


6.79 


3.68 



12 A Dietary Study. 

The amount of butterine is not excessive, and increases during the cold 
weather, as would be expected. 

CLASSIFICATION OP GROUPS OP FOODS. 
All four kitchens, each of six months — per cent of calories of total calories. 
Glasses. 

Breadstuffs 

Vegetables 

K ru its 

Sugar, sh-up 13 . 60 

Lard, butterine 

Milk, cheese, eggs 

Meats, fowls, fish 36.50 31.28 39.77 26.59 33.64 24.41 

This shows a great variation in the different months; and although one 
class may take the place of another to a certain extent, yet it would seem 
that it should be more uniform. 

FOOD COST, PER CAPITA. 

A practical study of the per capita cost of food for inmates of peni- 
tentiaries in some of the surrounding states is given below. More de- 
tailed information will be furnished on this point when comparison with 
the different institutions is completed. 

Cost per day 
per capita. 

Indiana penitentiary (Michigan City) 14.9 cents. 

Kentucky penitentiary 17.3 cents. 

Minnesota penitentiary (Stillwater) 23.0 cents. 

Missouri penitentiary 24 . cents. 

Illinois penitentiary (Joliet) 37.0 cents. 

Kansas penitentiary (Lansing) 39.5 cents. 

SUMMARY. 

1. Since the amount of food supplied appears to be higher than neces- 
sary, it should be decreased as much as can be done without injury to the 
health and well-being of the inmates. 

2. The use of 20 per cent of corn meal, rye flour or some other sub- 
stitute in the bread is to be commended. Bolted corn meal, rather than a 
corn flour that has been degerminated and thus deprived of most of its 
fat, is recommended for use. 

3. The amount of sugar products and sirup is still too high. Although 
starch is a satisfactory food when muscular exertion is required, if a 
part of it is replaced by sugar there is less tendency to fatigue. As 
much as five ounces per day can be utilized in the body, but so much is 
not necessary. 

4. If more lard is used than is furnished by the farm, a substitute con- 
sisting largely of vegetable oils and fats, a number of which are on the 
market, may be substituted for a part of the lard purchased, at a con- 
siderable saving. 

5. As the protein foods, such as meats, sausage, etc., are usually the 
most expensive part of the diet, these should be diminished, in the interest 
of economy. 

6. Fish is more rapidly and justoas completely digested as meat. It 
is extensively used as a part of the dietary of most public institutions. It 
will add to the variety of the diet, and if bids were asked for a definite 
delivery per week, its use might diminish the cost of protein foods. 



Kansas State Penitentiary. 13 

7. The use of larger quantities of vegetables and fruits, especially in 
season, will add greatly to the bulk of the food, and allow a decrease of 
the heavier staple foods. If the vegetables and fruits can be raised on the 
farm, so much the better. 

8. At the beginning of the season complete arrangements should be 
made by the purchase of a suitable canning apparatus to can large 
quantities of fruit and vegetables, especially corn, peas, tomatoes, sweet 
potatoes, pumpkins, peaches and pears. Much of this material can be 
raised on the farm. 

9. In some states, especially in Illinois, a system of dietaries is care- 
fully worked out for the institutions, and those in charge of the kitchen 
are required to follow them in the serving of meals to the inmates. 

10. As the matter of per capita cost of the food is involved in all the 
statements made above, no definite suggestions on this point are necessary. 



Lawrence, Kan , April 20, 1918. 
In order to arrive more accurately at the amount of food used in a 
given time, a careful account of food used in the main kitchen daily, 
from March 11 to April 9, 1918, inclusive, was made, and from the total 
amount of protein, fat, carbohydrates and calories for these periods the 
following per capita use of foods was determined: 

PER CAPITA USE OP POODS FOR FIVE-DAY PERIODS. 

Date. Protein. Fat. Carbohydrates. Calories. 

March 11-15 140.61 199.98 734.80 5,409 

March 16-20 113.40 226.80 548.80 4.587 

March 21-25 131.54 185.97 557.92 4,572 

March 26-30 154.22 172.36 604.80 5,698 

March 31 to April 4 127.00 204.00 585.00 4,416 

April 5-9 108.86 158.76 508.00 4,000 

Average 129.32 191.31 589.88 4,780 



Lawrence, Kan., October 10, 1918. 

Referring to a report on the dietary of the State Penitentiary at 
Lansing, under date of March 11, 1918, and to a supplementary report 
under date of April 20, 1918, on the food actually used for five-day 
periods from March 11 to April 9, the officers of the institution kindly 
gave the data for making another special test of the food for seven-day 
periods from May 12 to June 10. It was thought that a seven-day period 
would show more fairly the quantity of food actually used, as the coal 
miners especially cleaned up a certain amount cf coal in a weekly run, 
and did more work at the beginning of the week than at the end. This 
test was made especially to ascertain whether any improvement had been 
made in the direction of decreasing the actual amount of food used, as 
well as in diminishing the total protein and carbohydrates in the diet. 

The tests were made on the main kitchen and women's kitchen 
separately. As the number fed from the main kitchen is so much larger 
than that from the other kitchens, it is better to derive most of the con- 
clusions from an inspection of these figures. 



14 



A Dietary Study. 



KANSAS STATE PENITENTIARY. 
Main kitchen, summary of seven-day periods, per capita use of food. 



Period. 


Attendance. 


Amount, 
pounds. 


Protein, • 
grams. 


Fat, 
grams. 


Carbo- 
hydrates, 
grams. 


Calories. 


May 12 to 19 


3,657 
3,700 
3,701 


4.30 
4.32 
3.S8 


167 
167 
145 


267 
244 
244 


562 
585 
467 


5,326 


Mav 19 to 26 


5,287 


May 26 to June 2 


4,872 


Averase 


3,716 


4.16 


159 


251 


538 


5,161 



CONCLUSIONS. 

A consideration of the results shown in the table for the three seven- 
day periods shows that the protein, fat and carbohydrates furnished are 
all very high, even for the average of the men fed from this kitchen. 
The protein is 167, 167, 145 grams per day per capita, while 125 grams 
would certainly be a great excess. Doctor Lan-2,worthy, an authority on 
nutrition, in the United States Year Book, Department of Agriculture, 
1907, gives the figures as for average of 162 studies of "Men at moderate 
muscular work," farmers, artizans, laborers, etc., protein 100 grams, 
with a total energy of the diet at 3,685 calories. Men at hard muscular 
work and athletes would of course require more food, but the average of 
such men belong to a different class from those in the penitentiary. 

As the fats and carbohydrates are also high, the average of the 
calories for the three periods studied is 5,161, which is at least 1,500 
more than necessary. 

A chart was made representing a comparison, expressed in ounces, of 
the daily per capita consumption of food at Lansing State Penitentiary 
from May 12 to June 1, 1918, and the daily per capita consumption of 
food in national training camps. The data, which were for young and 
vigorous men in hard physical training, using the training-camp messes, 
was obtained from the article "Diet of the United States Army Soldier in 
the Training Camp," by Dr. John R. Murlin, in the Journal of American 
Medical Association for September 21, 1918. 

The Lansing diet yielded 5,161 calories per day for the three weeks 
referred to. The training-camp diet messes yielded 3,963 calories per day. 

In regard to fresh beef, the Lansing dietary for each week is nearly 
50 per cent higher than that of the army messes. Fresh beef and pork 
taken together show that more is used at the Penitentiary than at the 
camps. In the case of bacon and sausage there is three times as much 
used as at the Penitentiary, and the fats from lard and compound are 
two and one-half times as much. 

Butter and butterine is about the same in both tables. Twice as much 
syrup is used at the Penitentiary, but much less sugar, as the sugar 
ration had been cut down. 

More than twice the weight of dried beans was used at the Peniten- 
tiary, and more cereals for each of the three weeks considered. 

Except in the case of the first week, more potatoes were consumed in 
the army messes than at the Penitentiary. 



Kansas State Penitentiary. 15 

More flour and more milk are consumed at the Penitentiary than in 
the camps. Dried and other fruits and vegetables do not show any 
startling difference in amounts. 

The figures all indicate that without any loss in efficiency of the men 
at work, and in the interests of health and economy, the total amount of 
food can be appreciably cut down. While we are saving food in. every 
possible way to send to our allies across the water, it is a suitable time 
to begin reforms in those institutions over which the state has control. 



II. 

STATE INDUSTRIAL REFORMATORY, HUTCHINSON. 

(Abstract of Report.) 



Lawrence, Kan., May 16, 1918. 

The dietary of the institution was furnished me by Mr. J. N. Herr, 
superintendent, from the quantity of food consumed for the months of 
July, 1917, to February, 1918, inclusive. In each case, from the total 
amount of food used and a knowledge of each food product, the pounds 
of protein, fats and carbohydrates were computed. From this it was 
easy to obtain the total calories or food value of each foodstuff used. 

Table A shows the amount of staples used per day per capita in each 
of the eight months. 

Table B, subdivision 1, shows the amount of food per capita per day. 

Table B, subdivision 2, is a comparison of dietaries for each of the 
eight months. 

Table C is a classification of groups of foods for each of the eight 
months studied. 

Table D shows the number of pounds and per capita of three food 
nutrients obtained from each of a selected list of foods. 

As illustrative of table A, the dietary for October is given. Fifty 
different food products were utilized in the dietary for the period studied. 

(16) 



State Industrial Reformatory. 



17 



KANSAS STATE INDUSTRIAL REFORMATORY. 
Dietary for October, 1917. 



Articles of Food. 



Pounds. 


Protein, 
pounds. 


Fat, 
pounds. 


Carbo- 
hydrates, 
pounds. 


Calories. 


13,680.00 


41.04 


41.04 


1,477.44 


2,927,520 


40.00 
900.00 






12.00 
536.40 


21,760 


202.50 


16.20 


1,407,600 


1,770.00 


37.17 


5.31 


112.13 


311,520 


1,200.00 


262.80 


15.60 


781.20 


2,010,000 


5,175.00 

30.00 

1,960.00 


750.37 

.30 

25.48 


869.40 

25.50 

1.96 




5,071,500 




104,640 


150.92 


131,320 


480.00 


5.76 


398.40 




1,636,800 


6.00 


.09 


.01 


.74 


1,590 


1,800.00 


25.20 


3.60 


86.40 


217,080 


40.00 


11 52 


14.36 


.12 


79,760 


75.00 


.67 


.15 


5.55 


11,925 


15.00 


.42 


.18 


2.85 


6,667 


20.00 


1.96 


1.82 


14.62 


37,500 


4.50 


.74 


.13 


3.42 


8,469 


6,000.00 


672.00 


60.00 


4,494.00 


9,618,000 


62.00 


5.14 


.37 


48.98 


99,696 


778.00 
360.00 




778.00 
3.24 




3,175,796 


48.24 


266.76 


584,640 


100.00 


9.20 


1.90 


75.40 


161,300 


200.00 


33.40 


14.60 


132.40 


360,600 


7,312.00 


241.29 


292.48 


365.60 


2,295,968 


1,425.00 


19.95 


4.27 


126.82 


283,575 


15.00 


1.32 


.36 


.58 


5,025 


6.25 
15.00 


.04 

.54 




.67 
1.47 


1,331 


.03 


3,765 


120.00 


29.52 


1.20 


74,40 


193,440 


1,500 00 


27.00 


1 50 


220.50 


456,000 


2,750.00 


38.50 


16.50 


602.25 


1,229,250 


2. ISO 00 


10.90 


2.18 


56.68 


130,800 


900.00 


7.20 


2.70 


711.00 


1,431,900 


753 . 00 


137.04 


148.34 




853,902 


2,100.00 
900 00 






2,100.00 
567.00 


3,809,400 


21.60 




1,067,400 


6,160.00 


55.44 


24.64 


240.24 


634,480 


3,300.00 


29 70 


3.30 


188.10 


409,260 


30.00 


3 50 


.12 


6.30 


18,300 


, 64,161.75 


2,757 54 


2.749 39 


13,462.94 


40,810,479 



Apples 

Baking powder. . 
Beans, navy 
Beans, green. . . . 
Beans, Mexican. 

Beef, fresh 

Butter 

Beets 

Oleomargarine. 

Catsup 

Cabbage 

Cheese 

Carrots 

Corn 

Crackers 

Egg compound . 

Flour 

Hominy 

Lard 

Macaroni 

Meal, corn 

Meal, oat 

Milk 

Onions 

Oysters 

Peaches 

Peas 

Peas, split, dry. . 
Potatoes, Irish . 
Potatoes, sweet. 

Pumpkins 

Rice 

Bologna 

Sugar 

Sorghum 

Tomatoes 

Turnips 

Yeast 



Totals 64,161.75 



KANSAS STATE INDUSTRIAL REFORMATORY. 
TABLE A. — Amount of staples used per day per capita for each of the eight months. 



Staples. 



Flour 

Macaroni 

Hominy and corn meal . 

Potatoes, Irish 

Potatoes, sweet 

Beans and peas, dry 

Sugar 

Sirup (in terms of sugar) . 

Beef, fresh and dried 

Pork, fresh and salt 

Lard and shortening 

Bologna sausage 

Butterine and butter 

Milk 



July 
and 
Aug., 
1917, 



Oz. 
14.72 
.20 
.016 

6.56 



3.04 
2.40 

22 
L71 
6 56 
1 04 

64 

.43 

7.52 



Sept., 
1917. 



Oz. 
19.36 
.20 
.77 
6.56 
2 24 
2.88 
2.24 



4.64 
.20 

1.13 
.88 
.73 

9.7^ 



Oct., 

1917. 



Oz. 

8.32 

.50 

.22 

2.08 

4.16 

3.04 

2.88 

.83 

7.20 



1.12 

.96 

.64 

10 24 



Nov., 
1917. 



Oz. 
17.60 

.21 
1.62 
7.52 
29.60 
2.40 
2.24 

.83 
6.88 
1.17 
1.17 

.88 

.72 
10 OS 



Dec, 
1917. 



Oz. 

14.72 
.13 
.60 

12.80 



2.72 
1.92 
.83 
5.76 
1.22 
1.12 
1.12 
.88 
10 72 



Jan., 
1918. 



Oz. 
14.72 
.15 



14.50 



2.72 
1 92 
2^56 
6.53 
1.02 
.60 



.18 
11 68 



Feb., 
1918. 



Oz. 
14.43 

.96 
.32 

4.48 



2.08 
1.92 
2.08 
5.76 
1.18 
.64 



Average. 



Oz. 

14.83 

.77 

.69 

7.73 

12 00 

2.69 

2.21 

1.22 

5.49 

1.89 

.87 

.89 

.62 

10.19 



2 — Dietary — 575 



18 



A Dietary Study. 



DISCUSSION OF RESULTS. 

It is noted with satisfaction that an average of 10.19 ounces of milk 
per day per capita is used. This is such a perfect food, to use in correct- 
ing deficiencies in diet, that the amount should be increased as much as 
possible. When produced on the farm, even when some of the fodder 
must be bought, its use tends to notably decrease the cost of living per 
capita. Dr. E. V. McCollum, the most recent authority on dietetics, ad- 
vises the daily use of 24 ounces of milk as a minimum. 

In considering table A the first thing noted is the irregularity of 
amounts of some of the supplies furnished. This is more probably due to 
inaccuracies of bookkeeping than to a real change in the amount of food 
furnished. If a supply for several weeks is issued to the kitchen at one 
time, a part of the amount is liable to be carried over from one month 
to the next, thus affecting the apparent food supplied to the inmates. 
As an illustration, 19.36 ounces of flour per day per capita is supplied in 
September and only 8.32 in October. It is evident from the average of 
the other months that about 14.5 ounces is used per day, but at least 25 
per cent of the wheat flour should be replaced by corn or some other 
cereal. 

There is great irregularity in the Irish-potato supply. This may be 
due to local causes, or to the accounting, as noted above. At any rate, 
with the present price of potatoes, their use should be pressed to the 
limit, and continued until new potatoes are fairly abundant. If the 
potatoes are kept in a dark, cool place and the sprouts thoroughly re- 
moved as often as they appear, the quality of the potato will not be seri- 
ously impaired. 

In the case of sugar there is a slight decrease in the amount used in 
the later months, but a notable increase in the sirup, so that the sum of 
both, which is 2.62 ounces in July and August, increases to 4 ounces in 
February. This total saccharine material is probably more than abso- 
lutely needed. 

The summary shows the amount of beef to be low in July and August, 
as should be the case in warm weather. This, however, seems to be 
more than replaced by pork. 

The butter and butterine used is not excessive. (This is hereafter 
referred to.) 

KANSAS STATE INDUSTRIAL REFORMATORY. 
TABLE B (1). — Amount of food per capita per day. 



Month. 


Population. 


Weight 
of food, 
pounds. 


Protein, 
grams. 


Fat, 
grams. 


Carbo- 
hydrates, 
grams. 


Calories. 


1917. 


23,684 
10,890 
11,408 
10,830 
10,850 

10,819 
9,968 


3.24 
4.61 
5.62 
5.41 
3.82 

4.77 
4.00 


86.18 
131.54 
108.86 
140.61 
123.47 

145 15 
122.47 


81.64 
104.32 
108.86 
131.54 
127.00 

95.25 
113.40 


553.39 
680.40 
535.24 
802.87 
598.75 

666.79 
639.47 


3,413 




4,249 




3,577 




4,966 




4,084 


1918. 


3,705 




4,235 






Average 


12,635 


4.49 


122 61 


108.86 


639.46 


4,032 



State Industrial Reformatory. 



19 



KANSAS STATE INDUSTRIAL REFORMATORY. 
TABLE B (2). — Comparison of dietaries for each of eight months. 



Month. 


Grams of 

protein 

per capita. 


Total 
weight. 


Weight 

of 
protein. 


Weight 

of fat. 


Weight of 

carbo- 
hydrates. 


Total 
calories. 




86.18 
131.54 
10S.86 
140.61 
123.47 
145.15 
122.47 


76,774.06 
50,290.50 
64,161.75 
58,614.75 
41,505.75 
51,625.00 
39,883.25 


4,503.13 
3,237.20 
2,747.54 
3,380.38 
2,935.00 
3,568.40 
2,628.75 


4,419.69 
2,567.56 
2,749.39 
3,200.79 
3,113.49 
2,299.37 
2,516.90 


28,894.26 
16,418.91 
13,462.94 
, 19,177.93 
14,362.83 
15,901.70 
14,133 92 


80 836 619 










November 

December 


53,780.518 
44,314,393 
40,966, 170 
i 2, 227,900 


February 


Average 


122.61 


54,693.58 


3,287.20 


2,981.02 


17,478.91 


49,888,503 



In considering a comparison of the dietaries for each of eight different 
months, as in table B (1 and 2), there is considerable variation in the 
per capita calories or heat units used, but the ratio between the sum of 
the fats and the carbohydrates together, and the protein, is fairly con- 
stant; that is, from 1:6 to 1:7. For some reason the protein used in 
July and August was low, which would indicate a vegetable diet. It has 
been previously noted that the beef was low during these two months 
and the pork high. 

The protein used varies considerably in the different months, but the 
average (122.47) is quite satisfactory, especially when we consider the 
age of the inmates and their necessity for abundant food. 

The calories (average, 4,032) is probably somewhat higher than neces- 
sary, as 3,500 would seem to be enough for good bodily health. If the 
sugar and sirup are diminished in quantity this will tend to reduce 
the amount of calories, and there will still be a sufficient quantity of 
nutritional foodstuffs. 

In regard to the proportion of fat compared to carbohydrates, although 
no very definite statements are made, the standards noted below are 
recommended by different authorities for men with moderate muscular 
work. Experience has shown that to a certain extent carbohydrates may 
replace fats, but bodily health and vigor cannot be sustained without 
considerable fat. The proportions at the Hutchinson Reformatory are 
quite satisfactory: 

ALLOWANCE OF FOODSTUFFS FOR A MAN AT MODERATE MUSCULAR WORK. 

Toit. Playfair. Gautier. 

Protein 118 gms. 119 gms. 107 gms. 

Fat 56 gms. 51 gms. 65 gms. 

Carbohydrates 500 gms. t 531 gms. 407 gms. 

On the consideration of the food substances necessary for the mainte- 
nance of the health and growth of the body — namely, the proteins, fats, 
carbohydrates, mineral salts, and water — it has been assumed that the 
mixed diet used will contain a sufficient quantity of mineral salts and of 
water for proper building up and repair of the body. Such beverages as 
coffee and tea, although of great value in the menu, furnish no nutritive 
substances and therefore are not considered. 



20 



A Dietary Study. 



KANSAS STATE INDUSTRIAL REFORMATORY. 
TABLE C. — fer cent classification of groups of fr ods for each of eipht months. 



Classes of Foods. 



Breadstuffs 

Vegetables 

Fruits 

Sugar, sirup 

Lard, butter, butterine 

Milk, cheefe, eggs 

Meats, fowls, fish 



July 












and 


Sept. 


Oct. 


Nov. 


Dec. 


Jan. 


Aug. 












46.98 


41.97 


30.24 


41.98 


42.12 


43.02 


15 99 


13.95 


18.22 


24.60 


13.32 


9.41 


2.97 


2.89 


7.18 


2.89 


4.38 


6.66 


8.93 


5.98 


11.95 


7.69 


7.73 


13.54 


9.99 


10.69 


12.04 


9.55 


11.76 


4.85 


6.98 


6.94 


5.82 


5.90 


5.15 


6.07 


6.96 


8.99 


14.53 


13 25 


15.98 


16.36 



Feb. 



45.34 

11.67 
5.54 

10.82 
7.78 
5.25 

13.78 



Table C shows what proportion of the total food used belongs in each 
of seven classes. Breadstuffs, vegetables and fruits together consti- 
tuted from 55.64 per cent of the food in October to 68.48 per cent in 
November, or an average of nearly two-thirds of the food used. There is 
quite a variation in the amount of sugar and sirup (taken together) used, 
as the per cent is twice as much in January as in September. More 
sugar can be taken care of by the body in winter than in summer, so 
this difference in amount is in the right direction. The same thing is 
true of the animal foods, which are higher in percentage used in the 
later months of the year. 

By an intelligent selection of foods in this way — that is, by pushing the 
use of cereals and vegetables in the summer and allowing more sugar, 
fats and animal foods in the winter — the health of the inmates will be 
improved and the cost of maintenance will be decreased. 

Table D shows in rather an interesting way from what foods the pro- 
teins, fats and carbohydrates are obtained during each month. The 
analysis of this table is perhaps best made from the average of the 
eight months, although the monthly variations are of interest. 

Since jwoteins from vegetable sources are usually much cheaper than 
those from animal sources, the use of vegetable proteins should be en- 
couraged whenever this can be done without sacrifice of health condi- 
tions. Although it is probably true that a diet containing protein en- 
tirely from peas, beans and cereals would not be satisfactory, yet there 
is little danger of crowding the vegetable diet too far under present 
conditions. With more than a third of the protein (35 per cent) com- 
ing from animal sources, there is no danger of an excess of vegetable 
protein; in fact, the animal protein might be much decreased without 
ultimate deficiency in this class of nutrients. 

Looking for the source of the fat in the diet, it is evident that at 
least 55 per cent of it is of animal origin. The butterine and oleo and 
the compound lards are largely of vegetable origin. While, as before 
stated, milk, cheese and eggs should be used as freely as possible, the 
oleo and compound lards for shortening (all vegetable fats) may be 
used to replace fat pork and the fat of beef. This means a saving of 
animal fats for export and a reduction of cost by the purchase of 
vegetable fats. 

There is not so much to be said of the source of the carbohydrates, 
for bread and breadstuffs must furnish at least one-half. The free use 



State Industrial Reformatory. 



21 



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22 A Dietary Study. 

of peas, beans, potatoes and vegetables releases some of tbe cereals for 
export, and tends to diminish cost of maintenance. The rather abundant 
use of saccharine products has already been discussed. It is understood 
that at least 25 per cent of vegetable substitute is used with the cereals. 
If corn is the substitute selected, a fresh bolted corn meal, made from the 
whole grain, is more nutritious than a corn flour made from the de- 
germinated cereal. 

SUMMARY. 

1. In order that a satisfactory check may be kept on the actual amount 
of food used, it is advisable to see that only the food actually used for 
each period, say of a month, be charged to the kitchen. 

2. The amount of sugar used should be decreased as much as possible, 
but this may partially be replaced by sirup, which is made mostly from 
corn. Sorghum can be raised in large quantities, and the use of this 
sirup will decrease the cost of maintenance. 

3. Increase the amount of milk used as rapidly as possible. It is 
not only a valuable food, but it contains certain little-known substances, 
often called "vitamines," that are essential to growth and bodily vigor. 

4. There would probably be no loss in physical and mental powers 
of the inmates, by cutting down the total amount of food used ten per 
cent. The proportion of the different food constituents is quite satis- 
factory. 

5. The intelligent selection of the foods used, so that less fat, meat 
and sugar are used in the warmer months, and more vegetables and 
fruits, will tend to improve the health of the inmates and at the same 
time will result in a diminished cost. 

6. Use vegetable protein as much as possible, at the same time de- 
creasing that from animal sources, with the exception of milk. Raise as 
many vegetables as possible on the farm, and can or dry for winter use. 

7. Since it is now possible to obtain butter substitutes made from 
the vegetable oils, and lard substitutes mainly from the same source, 
there is no objection to using as much of these as is necessary to yield 
the fat required. 

8. In the use of wheat substitutes, use fresh corn meal. 

9. Hoover's estimate of the amount of sugar necessary per day per 
capita is 1.58 ounces, while the average used in this institution is 2.21 
ounces. The sugar may therefore be diminished, while any deficit may, 
if necessary, be made up by the use of sirup. 

10. If it is possible in the vicinity of Hutchinson to make arrange- 
ments to serve fish, or if salted or frozen fish can be obtained for a 
portion of the year, the diet would be improved without increased cost. 



III. 

OSAWATOMIE STATE HOSPITAL. 

(Abstract of Report.) 



OUTLINE OF INVESTIGATION. 

Lawrence, Kan , September 26, 1918. 

The dietary of the institution for ten months, beginning July, 1917, was 
furnished by Supt. F. A. Carmichael. In each case the quantity of food 
used or issued to the kitchen was reported for each variety of food. 

Table A shows' the total amount of each food for each month, from 
which is computed the pounds of protein, of fats and of carbohydrates, 
and the total calories. A summary for each month, with the computation 
of the amount per day per capita, is given. 

As illustrative of this table, the food used for the month of October 
only is given, but all ten months are considered in the summary. 

Table B shows the per cent of two food nutrients obtained from each of 
eight classes of food for each month. 

Table C gives a comparison of the per capita use of some of the im- 
portant staples for each of the ten months. 

Table D gives a comparison of the dietaries for each of the ten months, 
showing the per cent of calories per capita of total calories. 

Table E is a summary of the dietaries for the ten months, showing the 
per capita use of food, and the cost. 

(23) 



24 



A Dietary Study. 



OSAWATOMIE STATE HOSPITAL. 
TABLE A— Dietary for October, 1917. 



Articles of Food. 


Weight, 
pounds. 


Frotein, 
pounds. 


Fat, 
pounds. 


Carbo- 
hydrates, 
pounds. 


Calories. 




387.50 

1,000 00 

3,420.00 

225.00 

109.00 

35.00 

20.00 

1,460.00 

723.00 

675.00 

885.00 

9,681 00 

1,358.00 

185.00 

13,190.00 

4 00 

144.00 

336.00 

481.00 

46.00 

17.00 

30.00 

7.00 

90.00 

17.00 

100.00 

471.50 

116.00 

464.00 

1,249.00 

320.00 

750.00 

25,400.00 

1.50 

57.00 

500 00 

1,641.00 

930.00 

1,000.00 

398 00 

69.00 

520 00 

2,020.00 

20.00 

120 00 

240 00 

30,538 00 

876.00 

3,000.00 

385.00 

38.50 

36 00 

231.00 

500 00 

675.00 

315.00 

1,590.00 

152 00 

1,472.00 

169.00 

55,040 00 

7,300 00 

1,000 00 

500.00 

114.00 


1.01 

16.00 
10.26 
8.10 
10.35 


8 10 
22.00 
10.26 


183.60 
681.00 
369.36 
155.70 


377,000 

1,350,000 

731 880 








306 000 




64.74 


283 073 




10.50 

2.86 

870.16 

476.45 

46.57 

527.46 


19,040 




.16 

328.50 

130.86 

14.17 

189.12 

1,403.74 

17.65 

1.48 

184.66 

.06 

1.29 

3.64 

138 52 

7.30 

2.19 

33 

.44 

2.52 


.08 

26.28 

10 84 

2.02 

15.93 

1,626 40 

1 35 

3.88 

26.38 

.00 

.14 

.28 

172.67 

5.65 

8.27 

.12 

4.01 

1.08 


5 800 




2 283 440 




1 146 678 




119 400 




1 384 140 


Beef 


9 487 380 




104.56 

104 34 

633.12 

.49 

3.74 

72.59 

1.44 


226,786 




207 940 




1 582,800 




1,060 




9 792 




139,440 




957,114 




34,546 




5.15 

1.20 

2.20 

17.10 

15.30 

69.70 

344 66 

85.60 

12.06 


47,134 




3,330 




21,196 




40,050 




27,744 




9.70 

46.20 

11.60 

3.24 

148.63 

3.84 

32.25 

2,844.80 

1.37 

1.70 

41.50 

233.02 

77.19 


12.10 

42.90 

10.72 

.92 

116.15 

.96 

2.25 

254 . 00 

.00 


1 3,500 




884,062 




220,864 




31,552 


Eggs 


743,155 


Figs 


16.32 

556.50 
19,024 60 


40,640 
1.077,750 




40,716,200 




2,493 




22.40 
395.00 


43 , 604 


Grits 


3.00 

548.09 

5.58 

1,000 00 

398.00 

.34 

4.68 

147.46 

.38 

.12 

22 32 

1,221.52 

128.77 

2,490.00 

1.15 

.04 

.86 

.23 

5 00 

2.70 

.94 

3.18 

1.06 

806.65 

133.17 

5.04 

43.80 


804 , 000 




2.660,061 




734 . 70 


1,495,440 




4.082,000 








1,624,636 




.48 

69.68 

337.34 

1.84 

.24 

23 04 

1,007.75 

132.27 

36.00 

5.39 

.23 

3.16 

1.61 

23.50 

3.37 

.94 

57.24 

.60 

110 40 

9.97 

90.72 

102.20 

21 00 

13 00 

.91 


4.07 

385.32 

1,337 24 

15.08 

3.24 

26.88 

1,526 90 


9,660 




844,480 


Meal, oat 


3,642,060 




32,260 




6,840 


Milk, condensed 

Milk 


181,680 

9,588,932 




765,624 






10,230,000 


Onions 


34.26 
3.27 
1.40 

24.94 
312 50 

85.72 

56.70 
155.82 

55.32 


76,615 


Oranges 


6.506 




11,808 


Peaches, canned 

Peaches, dried 


49,203 
645,000 
172,800 




108,360 




399,090 




105,792 




3,613,760 






580,515 




740.88 

1,598.70 

733.00 

380 50 

64.29 


1,532,160 


Potatoes, sweet 


3,263,100 




1,400 000 


Raisins 


16.50 
2.39 


802,500 




131,100 



Osawatomie State Hospital. 



25 



TABLE A.— Concluded. 



Articles of Food. 



Rice 

Suet 

Salmon 

Sardines 

Sausage, Vienna 

Sugar, granulated 

Sugar, powdered 

Sirup 

Spaghetti 

Tapioca 

Tomatoes, canned 

Tomatoes, fresh 

Turnips 

Wheat, cracked 

Yeast 

Totals 

Amount per day per capita 



Weight, 
pounds. 



55.00 
138.00 
102.00 

12.00 
788.50 
100.00 

20.00 
590.00 
135.00 

46.00 
408.00 
480.00 
217.00 

90.00 
120.00 



201,235.50 



Protein, 
pounds. 



37.44 

2.84 
220.78 



16.33 

.18 

40.89 

103.32 

1.95 

9.99 

14.04 



77 prams 



Fat, 
pounds. 



.16 

112.88 

14.40 

2.36 

174.25 



.54 

.04 

6.81 

45.92 

.21 

1.53 

.48 



117 grams 



Carbo- 
hydrates, 
pounds. 



48.09 

5,100.00 

20.00 

3,694.95 

103.00 

40.48 

136.32 

347.72 

12.37 

67.95 

25.29 



42,731. 



403 grams 



Calories. 



87,505 

472,650 

126,720 

14,652 

1,170 922 

9,251,400 

36,280 

6,660,090 

218,700 

73,968 

248,024 

1,182,440 

26,908 

135,090 

73,200 



2,973 



26 



A Dietary Study. 




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Osawatomie State Hospital. 



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28 A Dietary Study. 

Table B, part first, answers the question, Where did the proteins come 
from? There is some irregularity, as would be expected in a summary of 
this kind. It will be noted, however, that, on the average, most of the 
protein, namely, 37.91 per cent, comes from the cereals, including, of 
course, bread. This is as it should be. The next source of protein is 
beef, mutton, etc., which yield 20.65 per cent of the protein; and the 
third is cheese, milk and eggs, which yield 17.17 per cent of the protein. 
Dry beans yield 6.21 per cent and the fruit and vegetables 6.12 per cent. 
Potatoes, which are very poor in protein, yield 5.28 per cent. Pork yields 
a very little protein, namely, 4.06 per cent. A suggestion will be made in 
regard to the protein in the final discussion of results. It is interesting 
to note that the average per cent of protein for the ten months from 
animal sources is approximately 44 per cent, and from vegetable sources 
56 per cent. Since vegetable proteins are generally cheaper than those 
from animal sources, this proportion is in the interest of less expense. 

Table B, part second, answers the question, What is the source of the 
fats in the diet? An examination of this table shows that the largest 
amount, namely, 24.68 per cent, comes from oleomargarine. This is 
closely followed by beef and mutton, which furnish 20.64 per cent of the 
fat. The milk, cheese and eggs yield 17.41 per cent of the fat, while pork 
yields 15.93 per cent of the fat, compound lard and sausage 11.47 per cent 
of the fat, and other sources are negligible. 

An examination of table C will give some idea of the regularity or 
irregularity of the supply of materials. In some cases this may be 
slightly misleading, as, for instance, only a small quantity of Irish pota- 
toes was dispensed in October. This is no doubt made up for by the larger 
amount in September, and also by the issuance of more sweet potatoes 
than in any other month. It is interesting to note that the amounts of 
sugar per capita began to decrease in November and continued to de- 
crease until the end of the period. The average was 1.38 ounces per day 
per capita. The less amount, 0.92 ounce, as reported for April, is just 
about the amount at present allowed — that is, two pounds per month per 
capita — by the Food Administrator. I have no doubt that this low con- 
sumption of sugar is continued at the present time. A part of the sugar 
is replaced by sirup, as during April, with the lowest sugar report, we 
find the highest amount of sirup used. 

The amount of beef and mutton used is fairly uniform, with the ex- 
ception of January. It is possible that in this case the figures refer to 
the amount put in storage rather than to the amount actually consumed. 
In regard to the use of milk, every effort should be made to increase as 
much as possible the amount used. In the system of dietetics now recom- 
mended a larger amount than the 13 ounces here dispensed would be ad- 
visable, to preserve, as far as possible, the health of the patients. In re- 
gard to dried fruits, also, the amount used should be increased as much 
as possible. 

A study of table E shows several interesting points. First is the 
grams of the protein per capita. This runs from 72 grams in July to 
95 grams in January. This is probably a little low for patients of this 
class. The protein is higher in the later months, which is a commend- 



Osawatomie State Hospital. 



29 



OSAWATOMIE STATE HOSPITAL. 
TABLE E. — Summaries of dietaries for ten months. — Per capita use of food. 



Dietaries. 



1917 

July 

August 

September 

October . • 

November 

December 

1918. 

January 

February 

March 

April 

Average. . . 



Weight 
of food, 
pounds. 



2.45 
3.12 
3.58 
3. 18 

3.51 
3.52 



3.23 
3.36 

3.64 
3.17 



3 27 



Protein, 
grams. 



Fat, 
grams. 



75.0 
95.0 
108 
117 
104.0 
122.0 



101.0 
95.0 

117.0 
95.0 



102.9 



Carbo- 
hydrates, 
grams. 



414 

403 
390 
403 
562 
403 



409 
381 
412 
412 



Calories. 



2,641 
2,925 
2,880 
2,973 
3,047 
3,114 



2,928 
2,603 
3,102 
2,901 



2,911 



Cost 

per day 

per capita. 



.197 
.222 
.220 
.208 
.226 
.239 



.205 
.221 
.249 
.211 



$0 219 



able feature of the diet. In the next to the last column is given the 
calories per capita. A comparison of this list shows a variation from 
2,603 to 3,114, which, all things considered, is not too great a variation, 
and is higher in November, December and March than in other months. 
The February figure, 2,603, is a little low for a winter month. The 
average for the entire period corresponds fairly well with the best prac- 
tice, and is probably high enough, but the potein ratio should be changed 
a little so that more protein would be dispensed and less fat or carbo- 
hydrates. This protein could readily be made up if the amount of milk, 
cheese and eggs could be increased, or by the use of a little more animal 
food. Table E also allows a comparison in grams of the protein, fat and 
carbohydrates, but, in addition, the fact is brought out that the protein 
should be slightly increased at the expense either of the fats or of the 
carbohydrates. In regard to the cost per month, when the high cost of 
food is considered, the average per capita per day of 21.9 cents seems to 
be very satisfactory. 

SUMMARY. 

1. The first conclusion is that in general the food supplied is sufficient 
in quantity. 

2. Comparing the proportion of the different materials to make a 
well-balanced ration, it is suggested that more protein be furnished and 
that at the same time the amount of fats and carbohydrates be diminished 
so that the total number of calories furnished shall not be any greater. 

3. The protein may be increased by using more milk, cheese and eggs; 
or if this is not practicable, by the use of a little more lean meat. 

4. The cost of maintenance seems to be as low as could be expected 
when the increased cost of all staples is considered. 

5. The superintendent or the dietician who has charge of the food 
should so dispense it that the amount of all food be somewhat increased 
in the winter months. This applies especially to the fat and carbo- 
hydrates. Table D shows that more of the energy of the food was ob- 
tained from meats during December, January and February than during 
any other months, and that is as it should be. 



30 A Dietary Study. 

6. The amount of fruit, fresh and dried, should be increased as much 
as possible. An average of six per cent of the total calories (energy) 
was obtained from this source. 

7. The amount of milk used should be increased. It is well to note 
that a quart of milk has a food value of 650 calories and is equal to more 
than a half pound of bread, to a pound of baked beans, or to six pounds 
of potatoes. It should be regarded as a food and not a beverage. Milk 
has also exceptionally valuable properties which stimulate growth and 
bodily vigor. 

8. In the interests of economy, continue to use butter substitutes made 
from vegetable oils, lard substitutes from the same source, and sugar 
substitutes made from cornstarch. 

9. If fresh, salted or frozen fish could be obtained for use during a 
portion of the year the diet would be improved without increased cost. 

Supplementing this report, a study was made of each food served for 
the three meals both on the patients' and the employees' table for three 
days during the summer of 1918. As an illustration, to the patients for 
breakfast was served oatmeal, milk, meat and potato stew, bread, sirup, 
coffee; for dinner, cold sliced ham, mashed potatoes, stewed tomatoes, 
bread, butter and tea; for supper, boiled rice, apple sauce, cheese, sweet 
crackers, bread, butter and tea. The average of protein for patients was 
91.05 grams, and for employees, 111.85 grams. This is not a larger 
difference than would be expected between the two classes of people. 
The calories were 2,905 and 3,278, respectively. 



IV. 

GIRLS' INDUSTRIAL SCHOOL, BELOIT. 

(Abstract of Report.) 



Lawrence, Kan., December 24, 1918. 
The dietary for this institution from September 1, 1917, to August 31, 
1918, both inclusive, was sent me by T. E. Baird, steward. In making 
the abstract of the report I have given in detail only that for October, 
1917, which is as follows: 

GIRLS' INDUSTRIAL SCHOOL. 
TABLE A— Dietary for October, 1917. 



Articles of Food. 



Apples, canned 

Apricots 

Baking powder 

Beans, string 

Beef 

Beets 

Blackberries 

Butter 

Butterine 

Carrots 

Catsup 

Cherries 

Cheese 

Chocolate 

Corn flakes 

Cornstarch 

Crackers, soda 

Eggs... 

Flour, white 

Flour, Graham 

Gelatin 

Gooseberries 

Hominy 

Lnrd 

Macaroni 

Meal, corn 

Milk 

Oysters 

Peaches 

Pears 

Peas 

Pineapple 

Pork, fresh 

Potatoes, Irish 

Potatoes, sweet 

Pumpkins 

Salmon 

Sardines 

Sugar, brown 

Sugar, granulated 

Simp 

Tomatoes 

Yeast 

Totals 

Amni'nt per dav ner cn'tn 



Weight, 

pounds. 


Frotein, 
pounds. 


Fat, 
pounds. 


( i '. - 
hydrates, 
pounds. 


Calories. 


366.00 


0.79 


3.16 


147.31 


289,080 


180 00 


1.62 


.00 


31.14 


61,200 


40.00 


.00 


.00 


12.00 


21,760 


120.00 


1.32 


.12 


4.56 


11,160 


613.00 


88.88 


102.98 


.00 


600,740 


42.00 


.54 


.04 


3.23 


7,014 


60.00 


.48 


1.26 


33.84 


67,440 


145.00 
120 00 


1.45 
1.44 


123.25 
99.60 




505,760 


.00 


409,760 


264.00 


2.37 


.52 


19.53 


41,976 


18.00 


.27 


.03 


2.21 


4,770 


72.00 


.64 


.57 


11.44 


24,336 


76.00 


21.88 


27.28 


22 


151,544 


36.00 


4.74 


17.53 


10.90 


99,792 


378.00 


20.79 


5.67 


306.18 


616,518 


48.00 


.00 


.00 


43.20 


78,336 


309.00 


30.28 


28.11 


225.87 


579,375 


106.50 


12.67 


9.90 


.00 


63,367 


1,000 00 


112.00 


10.00 


749.00 


1,603,000 


200.00 


27.60 


3.80 


143.80 


326,600 


180.00 


164.52 


■1£ 


.00 


299,160 


90.00 


.99 


.00 


18.99 


37,350 


399.00 


33.11 


2.39 


315.21 


614,592 


400 00 


.00 


400 00 


.00 


1,632,800 


35.00 


4.69 


.31 


25.93 


56,840 


300.00 


27.60 


5.70 


226.20 


4S3.900 


9,647.50 


318.36 


385.90 


4S2.37 


3,029,315 


90.00 


7.92 


2.16 


3.51 


19,980 


270.00 


1.89 


.27 


29.16 


57,510 


ISO. 00 


.54 


.54 


32.40 


61,920 


330 00 


11.88 


.66 


32.34 


82,830 


ISO. 00 


.72 


1.26 


65.52 


125,280 


311 00 


23.32 


170.42 


.00 


763,505 


1,140 00 


20.52 


1 14 


167.58 


346,560 


50.00 


.70 


.30 


10.95 


22,350 


99.00 


.79 


.19 


6.63 


14,850 


240.00 


46.80 


18.00 


.00 


158,400 


60.00 


13.80 


11.82 


.00 


73,260 


300.00 


.00 


.00 


285.00 


517,200 


800 00 


.00 


.00 


800.00 


1,451,200 


180.00 


.00 


.00 


144.90 


261,180 


2.-6. 00 


4.75 


.79 


15.84 


40,788 


16.00 


1.87 


.08 


3.36 


9,760 


19.817.00 


1,014.53 


1,435.93 


4,410.32 


15,694,058 


3 41 








2.707 



(31) 



32 



A Dietary Study. 



SUMMARY AND DISCUSSION. 

Referring to the tables herewith submitted of the dietary for each 
month from September, 1917, to September, 1918, these tables show 
considerable irregularity in the amount of food issued. I called your 
attention to this fact and learned, through the superintendent, that this 
was due to the peculiar conditions at this institution, as they had no 
storeroom where it was possible to keep a large proportion of the stock 
on hand. Such items as fruit, vegetables, etc., must be kept in the re- 
frigerators in the kitchens, so they were at all times accessible to the 
steward and could not be issued, as in most of the other institutions, on 
a daily requisition to the storeroom. This accounts for many of the 
irregularities appearing in the tables. 

In reference to the use of butter and butterine (table A), it is noticed 
that the use of butterine increased from the beginning of the year, so 
that it was from twice to three times as much as butter. This practice is 
to be commended. Although considerable butter should be used, it is 
by no means necessary to have more than one-third of the butter fat in 
that form. 

The amount of milk decreased from 2,054 gallons in January to 777 in 
August. The larger amount used should be kept up if possible. 

The calories obtained from the sugar were much more than those 
from the sirup. The sweetening is of practically equal value, whether 
obtained from sugar or sirup, and in many of the institutions a large 
proportion of the sweetening is obtained from sirup on account of its 
cheapness. 

The use of corn meal began to increase in the spring months. The 
increasing use of this carbohydrate is to be commended. 



GIRLS' INDUSTRIAL SCHOOL. 
TABLE B. — Summaries of dietaries for twelve months. — Per capita use of food. 



Dietaries 


Attend- 
ance. 


Weight 
of food, 
pounds. 


Protein, 
grams. 


Fat, 
grams. 


Carbo- 
hydrates, 
grams. 


Calories. 


Cost 
per 
day. 


1917. 


5,490 

5,797 
5,670 
5,797 

5,859 
5,292 
5,735 
5,520 
5,859 
5,850 
6,907 
6,138 


4.47 
3.41 
5.21 
5.39 

5.85 
5.55 
4.69 
5.72 
4.59 
3.39 
3.74 
3.04 


95 
77 
104 
99 

104 
104 
81 
108 
108 
81 
72 
68 


86 
108 
151 
131 

145 

118 
86 
86 
95 
99 
81 
91 


549 
344 
462 
462 

494 
408 
381 
553 
462 
385 
385 
276 


3,404 

2,707 
3,821 
3,483 

3,742 
3,109 
2,685 
3,511 
3,267 
2,820 
2,574 
2,234 


$0.16 


October. 

November 


.18 
.21 
.16 


1918. 

February 


.29 
.17 
.11 




.18 


May 

July 

August 


.17 
.12 
.13 
.23 






4.58 


91 


106 


430 


3,113 


$0,175 



From table B it is noted that the protein varies from 68 grams to 
104 grams. This variation may be partly due to the irregularities of is- 
suing the food as noted above. The fat per day per capita varies from 
81 grams in July to 151 grams in November. This variation is in the 



Girls' Industrial School. 33 

right direction, and it is noticed that in general more fat was supplied 
in the fall and winter than in the summer, as should be the case. 

Table B is a summary of the dietaries for the twelve months, and 
this also shows considerable irregularity, but that would have but little 
bearing on the average. The weight of food is 4.58 pounds per day per 
capita, and the protein shows an average of 91 grams. This amount is 
a little low, as most authorities agree that for growing girls — although 
as much may not be required as for men at ordinary labor — something 
over 100 grams should be provided. The proportion of fat to protein, an 
average of 106 to 91, is fairly satisfactory. This fat comes from butter, 
oleomargarine, lard, milk and beef. It is important that milk and butter 
should be retained at as high a proportion as possible. The cal- 
ories as noted on this table are quite irregular in the different months, 
varying from 2,234 to 3,821. I am convinced that this variation in the 
amount of energy in the food dispensed does not represent the actual 
condition at the institution, for the variation is greater than could be 
expected. The average of 3,113 is fairly satisfactory, considering the 
character of the inmates, but a variation of over 60 per cent in the cal- 
ories from August to November would not be expected. 

Table C gives the amount of some of the important staples used for 
each month. The per cent by months is of no value, for the reason 
above stated, but the average in ounces per day per capita can be stated. 
This is shown in the last column. This indicates, among other things, 
that 6.08 ounces of flour is used by each person per day. The amount of 
sugar decreased during the year, the average being 1.75 ounces per day, 
or 3.25 pounds per month per capita. This is more than the ration which 
was in effect under the Food Administration of two pounds per month 
per capita. The sirup, in terms of sugar, amounted to 3.75 pounds for 
the month. This might well have been decreased so as to bring the sugar 
down to the two pounds per month, as required by the Food Administra- 
tion. The amount of milk, an average of 31.22 ounces, nearly a quart per 
day, is quite satisfactory. It is possible that the three-fourths pound of 
potatoes used daily might have teen somewhat increased to take the place 
of some of the flour or other cereals used. 



3 — Dietary — 575 



34 



A Dietary Study. 



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Girls' Industrial School. 



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36 A Dietary Study. 

Table D shows in a condensed form where the total energy expended 
comes from. Although this varies considerably in the different months, 
due to the cause previously mentioned, we can get a general idea from 
the figures given. It is noted that breadstuffs furnish from one-fourth 
to three-fifths of the energy, vegetables about 12 per cent, sugar and 
sirup a varying quantity from 3.70 to 14.20, with an average of about 8 
per cent. The amount of energy furnished by milk, cheese and eggs is 
nearly one-fifth of the total energy. This proportion is to be commended. 
Meat, fish and fowls furnish a small proportion, considerably less than 10 
per cent, of the energy. Comparing these groups, it should be noted 
that starch and other carbohydrates come from the breadstuffs and 
vegetables, fruits and sugar; lard, butter, oleomargarine, eggs, milk and 
meat furnish most of the fat; and the milk, eggs and meat furnish 
most of the protein. It would be possible to increase the protein, as 
previously suggested, by bringing up the amount of milk, cheese, eggs 
and meats. 

Table B shows also the cost per day per capita. It is noted that the 
population varies within narrow limits, but the cost per month varies 
within wide limits. This is due to the conditions of storage, as previously 
noted, and affects the cost per day per capita from 11 cents to 29 cents. 
The average of this, 17.5 cents, no doubt represents the actual cost, and 
is commendably low. 

RECAPITULATION. 

1. The value of the monthly study of the dietaries at this institution 
is much impaired by the fact that the provisions cannot be issued daily 
from the storercom. An imperative need of this institution is a com- 
modious warehouse and storeroom for taking care of the supplies issued. 
This will be a great saving in handling and also in preventing waste. 

2. The amount of milk used is large, and this practice should be con- 
tinued, with the attempt to keep up the maximum quantity throughout 
the entire year. 

3. A part of the sugar used might be replaced by sirup with no less 
to the nutritive ratio, and at less cost. 

4. The protein used should be somewhat increased. Although, as 
above stated, the amount of milk used is large, the beef and vegetable 
protein like beans, peas, etc., should be increased to bring up the protein 
value to at least 105 grams. 

5. The total amount of food is probably a little low for inmates of 
this character — that is, a little more generous feeding should be prac- 
ticed, and this increase can be wherever most convenient, but some of it 
must be in meat and in vegetable proteins. It is possible that if greater 
regularity of calories furnished could be secured the total amount as it 
stands might be high enough. 

6. The cost per month as compared with other institutions is, of 
course, low, and it would be advisable to improve the quality even if the 
cost is raised three or four cents. 



V. 

TOPEKA STATE HOSPITAL. 

(Abstract of Report.) 



Lawrence, Kan., November 11, 1919. 

Following is an abstract of the report on the dietary of the Topeka 
State Hospital: 

Table A represents the total food that was used during the year be- 
ginning October, 1917, with a study on the amount of nutritive ma- 
terial derived from each food. In all cases the weight of the food as 
purchased is used in making the calculations. On making an abstract 
of the report I have given in detail here only the figures for September, 
1918. 

Table A here given, which covers the dietary in the Topeka State 
Hospital for the year ending September 30, 1918, shows the actual 
weight of each food issued per month, the actual number of pounds of 
protein, fat and carbohydrates for each month, and the calories, denoting 
the energy value of each of the foods. This means that from the 
analysis of each of these foods we have the per cent of the protein, fat 
and carbohydrates, from which we can readily calculate the quantity of 
each of these nutrient substances. These different constituents are all 
necessary for the maintenance of bodily health and strength, and in 
addition to these, most foods contain mineral salts, which are also 
essential. The most important source of the protein foods, as will be 
seen by an examination of the quantities of protein shown in the table, 
are beef, milk, cheese and eggs. The fat evidently comes largely from 
the beef, butterine, lard compound, milk, pork and sausage, and the 
great source of carbohydrates is flour, crackers, green corn, oatmeal, 
Irish potatoes, rice, and the sugar and sirup compounds. Looking over 
the table, furthermore, it will be noticed that the greatest quantity of 
calories or energy available from these foods comes from the flour, the 
next in quantity from beef, followed by sugar or sirup, then by milk, 
pork, potatoes, eggs, butterine, and miscellaneous starchy foods. These 
evidently furnish the great bulk of the nutrients; the other foods used 
are, however, of primary importance because they give variety to the 
food, and many of them furnish mineral salts, which are also important. 

The important food ingredients must be in the right proportions to 
produce what is ordinarily known as a balanced ration. It has been 
shown by many experiments that one variety of nutrients can, to a cer- 
tain extent, take the place of another, but this cannot be carried on in- 
definitely in the diet without .causing serious injury. Thus a diet con- 
sisting almost exclusively of starchy foods will ultimately produce a con- 
dition similar to starvation, and man cannot, in present civilized society 
at least, live "by meat alone," although some uncivilized tribes seem to 
live almost exclusively on fish. 

A further consideration of comparisons in these tables is taken up in 
the summaries which follow. 

(37) 



38 



A Dietary Study. 



TOPEKA STATE HOSPITAL. 
TABLE A.— Dietary for September, 1918. 



Articles of Food. 



Weight, 
pounds. 


Protein, 
pounds. 


Fat, 
pounds. 


Carbo- 
hydrates, 
pounds. 


Calories. 


616.00 


1.84 


1.84 


66.52 


131,824 


650.00 


10.40 


14.30 


429.64 


856,700 


84.00 


.75 


.00 


14.53 


28,560 


300.00 


14.10 


3.00 


187.50 


378,000 


335.00 


31.82 


198.99 


.00 


869,995 


190.00 


.00 


.00 


57.00 


108,800 


1,160.00 


261.00 


20.88 


691 36 


1,814,240 


1,200.00 


217.20 


18.00 


790.80 


1,903,200 


900.00 


198.99 


11.79 


591.75 


1,545,075 


30 00 


.33 


.03 


1.14 


2,790 


100.00 


2.10 


.30 


6.90 


17,600 


16,366.00 


2,373.07 


2,749.48 


.00 


16,038.680 


385.00 


5.00 


.38 


29.64 


64,295 


86.00 


.69 


1.83 


49.05 


100,050 


2,760.00 


33.12 


2,290.80 


.00 


9,411,600 


1,000.00 


143.00 


238.00 


.00 


1,271,000 


325.00 


2.92 


.65 


24.05 


51,675 


501 . 00 


144.28 


179.86 


1.50 


998,994 


280.00 


38.36 


34.44 


.00 


210,280 


21.00 


1.32 


12.05 


6.61 


63,588 


840.00 


23.52 


10.08 


159 60 


373,800 


7,377.00 


88.52 


29.50 


568.03 


1,313,106 


26.00 


1.43 


.39 


21.06 


42,406 


336.00 


.00 


.00 


302.40 


548,352 


234.00 


22.69 


28.31 


163.09 


452,790 


375.00 


37.50 


35.25 


276.75 


714,000 


552.00 


54.09 


50.23 


403.51 


1,035,000 


560.00 


3.92 


1.12 


14 56 


38,082 


2,612.00 


310.82 


242.91 


.00 


1,554,140 


600.00 


25.80 


1.80 


445.20 


862,200 


24,800 00 


2,777.60 


248.00 


18,575.20 


39,754,400 


29.00 


.29 


.49 


3.80 


7,375 


180.00 


2.34 


2.88 


26.82 


61,000 


800.00 


66.40 


4.80 


622.00 


1,320,000 


1,025.00 


181.65 


191.03 


.00 


1,113,774 


360.00 


.00 


360.00 


.00 


1,469,520 


2,750 00 


253.00 


52.25 


2,073.50 


4,435,750 


2,670.00 


459.24 


200 74 


1,820.50 


4,958,250 


43,163.00 


1,424.37 


1,726.52 


2,158.15 


13,553,782 


48.00 


4.60 


4.46 


5.37 


36,336 


6,462.00 


90.46 


19.38 


575.11 


1,285,938 


30.00 


2.64 


.72 


1.16 


10,050 


90 00 


.64 


.00 


9.85 


19,186 


450 00 


21.15 


4.50 


281.25 


567,000 


126.00 


.37 


.37 


22.68 


43,344 


350.00 


9.80 


18.90 


255.15 


572,250 


1,050 00 


37.80 


2.10 


102.90 


263,550 


90.00 


.36 


.63 


32.76 


95,974 


225.00 


2.25 


.00 


36.20 


88,875 


2,078.00 


155.85 


1,138.74 


.00 


5,101,490 


18,290 00 


329.22 


18.29 


2,688.63 


5,560,160 


5,230.00 


73.22 


31 38 


1,145 37 


2,337,810 


775.00 


13.95 


.00 


482 05 


899,775 


20,500.00 


205.00 


20.50 


533 00 


1,230,000 


575 . 00 


13.22 


17.25 


393.87 


809,025 


1,700.00 


136.00 


5.10 


1,343.00 


2,704,700 


1,500.00 


195 00 


660.00 


16.50 


3,078,000 


610.00 


73.81 


2.44 


465.43 


988, 200 


5,460.00 


38.22 


10.92 


245.70 


562,380 


4,700.00 


.00 


.00 


4,700.00 


8,525,800 


25.00 


.00 


.00 


25.00 


46,350 


4,640 00 


.00 


.00 


3,735 20 


6,732,640 


864 00 


10.36 


1.72 


34.56 


88,992 


25,984.00 


233.85 


103 . 93 


1,013.37 


2,676,352 


2,310 00 


20.79 


2.31 


131.67 


286, 44J 


200.00 


22.20 


3 40 


151 00 


328,200 


50.00 


5.85 


.20 


10.50 


30,500 


220,990 00. 


10,910.08 


11,030 25 


49,019.43 


154,363,497 


4.17 


86 grams 


90 grams 


426 grams 


2,920 



Apples, fresh 

Apples, dried 

Apricots, canned 

Apricots, dried 

Bacon 

Baking powder 

Beans, white 

Beans, Lima 

Beans, Mexican 

Beans, string 

Beans, green 

Beef 

Beets 

Blackberries, canned 

Butterine 

Beef, corned 

Carrots 

Cheese 

Chickens 

Cocoanut 

Corn, canned 

Corn, green 

Corn flakes 

Cornstarch 

Crackers, cream 

Crackers, Graham 

Crackers, soda 

Cucumbers 

Eggs 

Pigs 

Flour 

Gooseberries 

Grapes, canned 

Grits 

Ham 

Lard compound 

Meal, corn 

Meal, oat 

Milk, fresh 

Milk, condensed 

Onions 

Oysters 

Peaches, canned 

Peaches, dried 

Pears, canned 

Pears, dried 

Peas, canned 

Pineapple 

Plums, canned 

Pork, fresh 

Potatoes, Irish 

Potatoes, sweet 

Prunes 

Pumpkins 

Raisins 

Rice 

Sausage 

Spaghetti 

Squash 

Sugar, granulated 

Sugar, powdered 

Sirup 

Tomatoes, canned 

Tomatoes, fresh 

Turnips 

Wheat, cracked 

Yeast 

Totals 

Amount per day per capita 



Topeka State Hospital. 



39 



TOPEKA STATE HOSPITAL. 
TABLE B. — Summaries of dietaries for twelve months. — Per capita use of food. 



Dietaries. 


Weight 

of food, 
pounds. 


Proteins, 
grams. 


Fat, 
grams. 


Carbo- 
hydrates, 
grams. 


Calories. 


Cost 
per 
day. 


19,17. 

October 

November 

December 

1918. 

January 

February 

March 


4.22 
3.32 
3.54 

2.63 
3.09 
2.85 
3.36 
3.23 
3.11 
3.33 
3.95 
4.17 


86 
84 
90 

90 
90 
86 
93 
86 
86 
92 
82 
86 


93 
104 

99 

77 
122 
95 
95 
86 
136 
77 
82 
90 


444 
312 
430 

403 
399 
408 
456 
421 
399 
449 
376 
426 


3,197 
2,500 
3,043 

2,777 
3,109 
2,865 
3,156 
2,879 
3,194 
2,888 
2,596 
2,920 


$0,213 
.192 
.226 

.213 
.235 
.230 
.228 




.257 




.257 




.244 




.257 


September 


.278 


Average 


3 40 


87 


96 


410 


2,927 


JO. 236 



The column marked "Calories," in table B, is of great interest, because 
this shows the total energy consumed, and the different months are 
strictly comparable. There is considerable variation in this table from 
a minimum of 2,500 pounds in November, 1917, to a maximum of 3,197 
pounds in October, 1917. 

The best information in regard to the number of calories per capita 
needed seems to point to the fact that something between 3,000 and 3,500 
calories of food are needed for a man occupied with ordinary work. It is 
true, however, that the inmates of this institution would hardly come 
under this class, so that it is quite right to consider that this figure might 
with safety be appropriately reduced. 

Some interesting data may be obtained from the total calories for the 
twelve months, which is 1,857,673,110. This represents the total food 
served during the year, and if we divide the total cost for the year by this 
figure and multiply by 1,000 it gives us the cost of energy units per 
thousand calories. This is .0812 cents. This is valuable for comparison 
with the data obtained from other institutions, although with the growing 
cost of living this figure will sensibly increase from year to year. 

It will be noticed that the weight of food used varies from 2.63 pounds 
per day for each of the inmates in January, 1918, to 4.22 pounds per 
capita in October, 1917. 

There is also shown in this table considerable variation in fat, which 
is brought out more especially in the per capita calculation. This runs 
through a rather large range, from 77 grams in January and also through 
July, to 136 grams in June. 

The amount of carbohydrates used varies between 312 grams in No- 
vember, 1917, and 456 grams in April. 



40 



A Dietary Study. 



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Topeka State Hospital. 41 

Table C is a comparison of the per capita use of some of the important 
staples. For the sake of easier comparison these amounts are reduced 
to ounces per capita and the important staples selected are those which 
represent very large averages of the food value. In some cases it is 
quite possible that a larger amount was charged to the kitchen than was 
actually used, and so some of it was held over in the kitchen. That 
would seem to be indicated by the low amount of flour in November, 3.52 
ounces, as compared with the average of the twelve months of 8.04 ounces. 

The amount of corn-meal grits used varies considerably, but as the 
total amount was comparatively small, that is not of much importance. 
It would have been better, perhaps, not to have used so much in June, 
July and August. 

In regard to Irish potatoes, what was said previously in regard to 
issuing flour to the kitchen may also apply here, as a very large quantity 
was issued in December and a very small amount in January; probably 
this should be distributed between the two months. July is exceptionally 
low, due, probably, to the scarcity of potatoes during that month and the 
month of August. Sweet potatoes are only issued during November and 
December, when they are abundant and readily obtainable. 

The amount of granulated sugar is 1.44 ounces, or a per capita con- 
sumption of 2.7 pounds per month. The allowance which was made dur- 
ing the scarcity of sugar by the government was an amount of two 
pounds per capita per month, and it is interesting to note that the amount 
used here is not very much above that recommended by the Food 
Administration. As will be noticed by comparison with the other state 
institutions, it is not as much as was used in some of. the others. The 
sirup may be made to take the place, to a certain extent, of the sugar, 
and there was a notable increase in the amount of sirup used during the 
spring months. Of course, if we consider sirup and sugar together, the 
amount of saccharine material used is considerably larger than the Food 
Administration had recommended. 

In regard to beef, the quantity is quite uniform throughout the year, 
with an average of 5.35 ounces per day. The same thing in regard to 
uniformity may be said of pork, which shows an average of .66 per day. 

Considering the lard and lard compound, which comes under the head 
of fat, the same discrepancy is again noticed for the month of June as is 
referred to in a previous table, but as there seems to be none mentioned 
in July or August, no doubt the amount issued in June was used during 
the following months. 

The average amount of milk used per day is 12.34 ounces, or about 
three-fourths of a pint. It is always well to increase the quantity of milk 
to the highest amount possible. The same thing may be said of fruits. 
For the health of the patients as large a quantity of fruits should be used 
as can be furnished without additional expense. 



42 



A Dietary Study. 







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Topeka State Hospital. 43 

The classification of groups of foods used and per cent of calories is 
shown in table D. These figures are obtained by comparison of the total 
calories of the food with the calories contained in each one of these groups 
of foodstuffs. Referring to the column marked "Average," it will be 
noticed that more than one-third of the calories, namely, 37.99 per cent, 
are obtained from the breadstuffs ; and next in order, 18.49 per cent from 
meats, fish, etc., while sugar and sirup follow with 11.21 per cent, and 
milk, cheese and eggs with 10.15 per cent. Thus it will be seen that these 
four classes of staples furnish 77.84 per cent of the calories, or more 
than three-fourths. 

An attempt should be made to increase the amount of vegetables and 
fruits during the portion of the year in which these are abundant. Com- 
paring the quantity of vegetables used in each month, it will be seen that 
to a certain extent this has been done. The cost per day is shown in 
table B. The total population was very uniform for the year, with an 
average of 1,747.4. There seems to be little relation between the cost 
per month and the total attendance. This probably could not be ex- 
pected, however, when food is carried over from month to month. 

The cost per day per capita is interesting, as it shows a gradual in- 
crease from 19.2 cents to 27.8 cents in September, following the rise in the 
prices of foodstuffs on the market. No doubt a comparison made during 
the current year would show still greater increase. The average for the 
year was 23.6 cents, which is certainly as low as could be expected, con- 
sidering the cost of foods. 

SUMMARY AND REMARKS. 

The dietary for an entire year has been studied so that any inaccu- 
racies of any particular month may be equalized in the average. 

1. If great care is used in issuing supplies to the kitchen, so that 
what is issued is actually consumed during the given month, it will 
make it much easier to make comparisons. 

2. It would be well to so regulate the diet that more food, and es- 
pecially more fatty food, should be used in the winter months than in the 
summer. The report of the steward does not show this to have been the 
case. 

3. A more careful study of the character of the individuals would be 
necessary to decide what amount of calories per capita per day would 
be sufficient, but, all things considered, it is probable that the amount in 
this institution might be somewhat diminished without impairment of 
the physical health. 

4. Although potatoes contain less than 22 per cent of nutritive ma- 
terial, and even if somewhat expensive as compared with former years, 
on account of their dietetic value, and because they can be prepared in 
such a variety of ways to stimulate the appetite, the quantity of potatoes 
used should be kept as high as possible. 

5. The amount of corn meal used might be increased during the winter 
months and decreased in the summer. A large amount of corn products 
should be used, on the score of cheapness, but care must be exercised 



44 A Dietary Study. 

not to push their use to a point where the appetite becomes surfeited 
with them, for in many respects wheat products are better food. 

6. On account of the high price of sugar, it is advisable to keep this 
down to 2.5 pounds per month per capita. If more saccharine material 
seems to be desired it can be made up by the use of sirup. 

7. Increase the quantity of milk as much as possible, for according to 
the latest theories of dietitians there is no food that will tend to improve 
the health of the patients more than an abundance of milk. Very few 
realize that the cost of milk per 100 calories is usually only one-half the 
cost of beef. As an illustration, it was found in New York City, on 
January 1, 1919, that 1,000 calories of energy cost as milk 24 cents, and as 
beef 45 cents. 

8. It goes without saying that the more vegetables that can be used 
the better for the quality of the dietary. As a well-known author says, 
"Scurvy appears when the diet contains no antiscorbutic vitamines, i. e., 
by using diets which are free from fruits, fresh vegetables, and tubers 
such as potatoes." 

9. The management is to be commended for keeping the cost of the 
food low. The gradual increase from 19.2 cents to 27.8 cents is no more 
than could be expected with the general increase of the cost of living. 

It is hoped that this data and the suggestions made from the study 
of the food in actual use at this institution may be of value in increasing 
the efficiency of the management and keeping the cost of the food as low 
as possible, considering at the same time the health of the patients. 



VI. 

STATE HOSPITAL FOR EPILEPTICS, PARSONS. 

(Abstract of Report.) 



Lawrence, Kan., May 17, 1920. 

The examination of the dietary of the Parsons State Hospital was 
undertaken with the object of ascertaining whether the quantity of food 
used is sufficient for the inmates; is the quality satisfactory? are the 
different nutritives so distributed that there is a sufficient proportional 
quantity of carbohydrates, fats and proteins for complete nourishment? 
whether it is possible to substitute cheaper foods for those issued and 
still keep up the proper dietary; could any other foods or a greater 
variety be added to the menu with advantage to the inmates? is there 
any unnecessary waste in preparing, dispensing or serving the food? 
are all the waste products utilized as far as possible by feeding to ani- 
mals and in similar ways? can the cost be decreased without loss of 
food value or satisfactory service? 

With these objects in view the steward has been asked to furnish the 
quantity of each kind of food issued per month, and this investigation 
has been carried through from October 1, 1918, to September 31, 1919, 
thus covering an entire year and including both the winter and summer 
dietaries. 

The results given in table A have been compiled from the steward's 
report, and the following tables contain a discussion of the results, with 
suggestions in regard to any possible improvements that might be made. 

In order to eliminate from this abstract most of the details of the 
work, the tabulation for the month of September, 1919, only, is given. 

In table A is shown the weight in pounds, the protein, fats and carbo- 
hydrates in pounds, and the calories. A glance at the column headed 
"calories" shows where most of the energy of the food comes from, the 
highest numbers being bread, beef, butterine, beans, flour, lard, corn 
meal, milk, potatoes, rice and sirup. 

That there is a variety in the food may be inferred from the list of 
food materials given in the left-hand column. These for each month are 
as follows: 



Month. Varieties. 

October 59 

November 53 

December 49 

January 53 

February 55 

March 53 



Month. Varieties. 

April 61 

May 60 

June 52 

July 48 

August 55 

September 52 



(45) 



46 



A Dietary Study. 



STATE HOSPITAL FOR EPILEPTICS. 
TABLE A.— Dietary for September, 1919. 



Articles of Food. 



Apples 

Apple butter 

Apricots 

Apricots, dried 

Bacon 

Beans, green 

Beans, Lima 

Beans, navy 

Beans, Mexican 

Beef 

Bread 

Breakfast food 

Butterine 

Cabbage 

Carrots 

Cherries 

Corn 

Crackers, soda 

Cucumbers 

Eggs 

Figs 

Fish...., 

Flour, white 

Gooseberries 

Gra pes 

Grits 

Hominy 

Lard 

Lemons 

Macaroni 

Meal, corn 

Milk 

Onions 

Oysters 

Peaches 

Peanut butter 

Pears 

Pears, dried 

Peas 

Peas, split 

Plums 

Potatoes, Irish 

Potatoes, sweet 

Pumpkin 

Pudding 

Rice 

Salmon 

Spaghetti 

Sugar 

Sirup 

Tomatoes, canned 

Tomatoes 

Totals 

Amount per day per capita 



Weight, 
pounds. 



144 

ISO 

168 

200 

234 

861 

425 

800 

600 

7,824 

10,952 

108 

1,020 

600 

700 

120 

1,170 

266 

600 

270 

50 

660 

2,500 

150 

224 

200 

192 

1,000 

40 

220 

600 

31,100 

627 

30 

225 

50 

90 

•250 

1,080 

180 

378 

7,920 

700 

48 

120 

800 

120 

70 

2,500 

2,320 

2,050 

2,072 



85,895 



Protein, 
pounds. 



.28 

2.16 

3.19 

9.73 

22.23 

18.08 

76.92 

180.00 

131 40 

1,134.48 

1,018 53 

5.94 

12.24 

8.40 

6.30 

1.32 

32.76 

26.06 

4.20 

32.13 

2 15 

76.56 

280.00 

1.95 

2.24 

23 00 

4.20 



.28 

29.48 

55.20 

1,026 33 

8.77 

2.64 

1.57 

14.75 

.27 

7.00 

38 88 

44.28 

3.78 

142.56 

9 80 

.38 

6.60 

6.40 

23.10 

8.47 



24 60 
18.64 



4,591 17 



109 srams 



Fat, 

pounds. 



1.14 

.18 

2.18 

2 00 

138.99 

2.58 

6.37 

14 40 

7.80 

1,314 43 

131 42 

1.62 

846 60 

1.20 

1.40 

.12 

14.04 

24.20 

1.20 

25.11 

.15 

109.56 

25 00 

2 25 

2.92 

16 80 

.36 

1,000.00 

.20 

1.98 

1 4 

1,244 04 

1.88 

.72 

.22 

23.25 

13 50 
2.16 
1.80 



7.92 
4.20 

.09 
5.76 
2.40 
9.00 

.28 



4 10 

8.28 



Carbo- 
hydrates, 
pounds. 



53 56 
105 30 

81 98 
125 00 



59 41 
280.07 
476.80 
390 60 



6,771 70 

87.48 



28 80 
51.80 
25 32 
222 30 
194.44 
15.60 



37.10 



1,872.50 
28.65 
35.13 
144 60 
34.16 



2 36 

163.02 

452.40 

1,555.05 

55.80 

1.17 

24.30 

8.55 

16 20 

182.25 

105.84 

111.60 

75.96 

1,164.24 

153 30 

3.21 

33 00 

632 00 



53.41 
2,500.00 
1,767.60 

82 00 



Calories. 



105 

200 

168 

252 

507 

151 

674 

1,251 

1,005 

7,667 

12,857 

176 

3,478 

72 

111 

28 

520 

498 

40 

160 

71 

575 

4,007 

67 

80 

383 

72 

4,082 

5 

357 

1,027 

9,765 

124 

10 

47 

137 

30 

408 

271 

290 

114 

2,407 

312 

7 

97 

1,272 

79 

113 

4,535 

3,366 

211 

213 



64,585 



120 
700 
000 
000 
698 
536 
050 
200 
000 
520 
698 
148 
200 
600 
300 
840 
650 
750 
800 
650 
850 
080 
500 
500 
032 
000 
960 
000 
600 
280 
800 
714 
773 
050 
925 
050 
960 
750 
081 
160 
774 
680 
900 
200 
812 
800 
200 
400 
000 
320 
150 
416 



State Hospital for Epileptics. 



47 



STATE HOSPITAL FOR EPILEPTICS. 
TABLE B. — Summaries of dietaries for twelve months. — Per capita uee of food. 



Dietaries. 



Weight 
of food, 
pounds. 



Protein, 
grams. 



Fat, 
grams. 



Carbo- 
hydrates, 
grams. 



Calories. 



Cost 

per day 

per capita. 



October. . . 
November 
December . 



January . 
February. . 
March 

April 

May 

June 

July 

August. . . . 
September . 



1919. 



Average . 



4.31 

3.99 
4.20 



4.03 
4.16 

4.20 
5.21 
5.08 
5.82 
5 70 
5 26 
4 49 



99 
90 
95.0 



99.0 

104.0 

9.0 

118 

95.0 
109 
104.0 

95.0 
109 



113.0 
117.0 

72.0 



122.0 
104 
104.0 
127.0 
109.0 

108 
113.0 

109 
118 



508 
435 
512 



499 
462 
449 
544 
499 
463 
472 
472 
458 



4.70 



100.5 



109.6 



3,474 
3,199 
3,076 



3,545 
3, 2'M 
3,191 
3,847 
3,407 
3,310 
3,312 
3,284 
3,381 



SO. 34 
.31 
.31 



29 
.32 
.31 
.38 
.37 

34 
.32 
.35 
.32 



3,355 



$0.33 



The minimum "attendance" for the year was 17,508 for February and the maximum was 19,719 for May. 
Average for the twelve months, 628.5. 



Table B gives an opportunity to look at the dietary of the institution 
for the entire year. The protein or nitrogenous foods (such as meat, 
milk, eggs, etc.) are the most expensive, and there is this remarkable 
fact shown in the table, although it may be only a coincidence: In No- 
vember the weight of protein purchased was 3,723.21 pounds, the smallest 
of any month, and the same month was one of the lowest in per capita 
cost. A similar comparison for the highest protein named, that for April, 
shows that the cost per capita for this month was the greatest of any 
month. Considering this table further, under the head of "Calories per 
capita" (one of the fairest methods of comparison of the several months), 
it is noticed that these vary from 3,096 in December to 3,847 in April. 
Here again April shows a higher feeding than any of the other months. 
From what we know of calorie requirements, the amount of food issued 
in even the lowest months is sufficient for the wants of the inmates. An 
adult doing a fair amount of work each day expends not more than 3,300 
to 3,500 calories, and these inmates at this institution are quite a distance 
below the normal man in physical activities. The average of 3,355 should 
keep the patients in good condition and leave a margin to build up the 
body and add to their feeling of well-being. 

The weight of food here shown is interesting. In considering this it is 
well to remember that some of the food, as fats, sugar, etc., are very 
concentrated nourishment, while the meats and cereals contain 50 to 75 
per cent of water and the vegetables contain from 70 to 95 per cent of 
water. The four to six pounds of food issued is, therefore, not all 
nutritive materials, as fruit and vegetables contain so much water, and 
these are more extensively used in the summer. Other things being 
equal, the food supplied during the summer should be greater in weight 
to give the same amount of energy. Notice that the six months from 
April to September are all higher than the other half of the year. As 
to the amount of food needed, 50 to 60 ounces is usually considered 



48 



A Dietary Study. 



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State Hospital for Epileptics. 49 

enough. Amounts here vary from 64 to 93 ounces, which is certainly 
ample. 

Comparing the different months, three seems to be little relation 
between the cost and the attendance. The per capita cost per day is low, 
considering the increasing cost of living during the year. As previously 
noted, the month of April, when the protein was highest, shows the great- 
est per capita cost for food. 

Table C shows the amount per day of some of the most important 
foods used by each person in each month, and, for convenience, is calcu- 
lated to ounces. The average quantity of flour is 1.58 ounces; of pota- 
toes, 8.57 ounces. This is rather low during the months of May, July and 
August, when potatoes were perhaps scarce. Even at prevailing prices, 
the amount of potatoes used should always be as high as the dietary will 
stand. 

The sugar used was 4.4 pounds per month, and this is supplemented 
by 3.5 pounds of sugar in sirup used, making a total of 7.9 pounds of 
saccharine substances. During the period when sugar was very scarce, 
the Food Administration allowed two pounds per month per capita, so 
the amount of sugar used here is much larger than is positively neces- 
sary. Whether it can be reduced, considering the abnormally high price 
of sugar this year, and thus decrease the cost of food, is for the authori- 
ties of this institution to consider. 

Beef is always an expensive item, but an excellent source of protein 
and fat. Over one-fourth pounds per day per person seems to be an 
abundance, and possibly some might be replaced by beans and protein- 
yielding food. The meat used here, however, is not as much as at some of 
the other state institutions. 

From 18 to 31 ounces of milk for each of the inmates, or an average of 
a little less than a quart, is a good showing. This is one of the most 
valuable foods that can be used in this institution, and the quantity 
should be kept at as high a figure as possible. 

If some arrangement could be made so that even more fish could be 
used, it would lower the cost and increase the variety of foods. The 
fish should be fresh if possible, but if not, either salted or dried. 

Table D shows the source of the energy derived. Of the total calories 
nearly one-third comes from breadstuffs, and next in abundance is that 
from milk, cheese and eggs. This is satisfactory, for it is not advisable 
in this institution to depend too largely on meat for the protein and fat. 
More than one-seventh of the energy comes from the sugar and sirup. 
There is always a tendency to use large quantities of sugar because of 
its agreeable taste. The amount of fruit used should be kept as high as 
possible. 

In comparing the different state institutions so far studied, the Osa- 
watomie and Topeka hospitals are the only ones that are at all comparable 
with the Parsons institution, and the comparison should not be carried 
too far even with them. The amount of food used is greater at Parsons, 
and this gives a higher calorie and protein value per capita. Possibly the 
character of the inmates in Parsons necessitates this. The cost is also 
more, but these figures are made on a rising food market, the Parsons 
institution being the latest of the series examined. 

4 — Dietary — 575 



50 



A Dietary Study. 







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State Hospital for Epileptics. 51 

RECAPITULATION. 

1. As the food at this institution is prepared in the kitchens of fif- 
teen or more different cottages, there are some advantages not possessed 
by those institutions where the food is all prepared in one or two kitchens. 

2. An examination of the food supplied indicates that the quality is 
good. In a few cases where a question arose as to the quality, samples 
were taken and examined at the State Food Laboratory in Lawrence. 
The report on these is as follows : 

Tomatoes: Refraction of filtered juice, 33.6; acidity as lactic acid, 
0.73; appearance of content, good. 

Catsup: Appearance, good; no artificial color or preservatives de- 
tected. 

Rice: Appearance, good; glucose, none detected; talc, present. This 
latter ingredient is unnecessary, but is often used to improve the ap- 
pearance of the product. 

Vanilla flavor: No adulteration found. 

Prunes: These had a soured or moldy odor, and on examination 
showed that insects were present. If used they should be thoroughly 
washed several times and the water thrown away. 

3. The necessary waste from the preparation of the food and left- 
overs not edible is fed to hogs, and the hogs are sold, so that it is probable 
that a much smaller actual waste occurs here than in the ordinary city 
household. 

4. The food given out by the storekeeper is used for the patients, ad- 
ministrative force and helpers, and as the latter force is large, this brings 
up the necessary amount of food above what it would be if patients alone 
were fed. 

5. Farm products are used as much as possible. This not only dimin- 
ishes the cost, but it affords a greater variety of food. 

6. The examination of the dietary indicates that one practical method 
for reducing expenses is to decrease the protein, especially that from 
meat. 

7. The energy of the food, as shown by the calories per capita, is 
sufficiently high for an institution of this class. In fact, the amount of 
food might be slightly decreased without any injury to the patients. 

8. Although the weight of the food served is greater in the sum- 
mer months, there is no increase in calories at that time — a condition 
which is satisfactory. 

9. If the amount of sugar and saccharine substance can be reduced 
during the present high price of sugar, it should be done, and the patients 
will not suffer. It may be possible to substitute sorghum for some of 
the sirup in the fall. 

10. The amount of milk used is to be commended. It should be kept 
as high as possible. 

11. That the institution has been able to use so much fish to replace a 
part of the meat is to be commended. Most fish is readily digested and 
adds variety to the diet. 

12. Table D shows that 11.1 per cent of the total calories comes from 
meat and fish. All things considered, this is sufficiently high and would 
allow a small decrease without injury to the diet. 



52 A Dietary Study. 

13. The cost per day per capita did not rise during the year, but this 
may be largely due to the purchase of most of the food by contract. If 
food had been bought on the open market a gradual increase would have 
probably been shown. 

14. The calories and the cost of food are greater at the Parsons Hos- 
pital than at either the Osawatomie or the Topeka Hospital, but it must 
be remembered in comparing cost that the Parsons institution was 
studied a year later than the other two and during the time of a rising 
food market. 

15. In the comparison of tables it should be noted that the bread was 
purchased at the Parsons institution, so the amount of flour is low. The 
high milk and low pork consumption is well shown here. The quality 
of the bread used in the Parsons Hospital might be improved. The 
process of raising is carried too far, thus giving a larger loaf for the 
amount of flour used, but producing slight acidity in the bread. 

16. The cost for 1,000 calories represents the actual cost of energy 
supplied by the food. The increase of the Parsons institution over the 
other two hospitals can be accounted for by the later date of this in- 
vestigation. 



VII. 

STATE SCHOOL FOR THE BLIND, KANSAS CITY. 

(Abstract of Report.) 



Lawrence, Kan., March 3, 1921. 

An abstract of the report on the dietary of the Kansas State School for 
the Blind, at Kansas City, Kan., is herewith submitted. The objects of 
the investigation were the same as for the institutions already studied. 

With these objects in view, the steward has been asked to furnish the 
quantity of each kind of food issued per month, and this investigation 
has been carried through from January, 1919, to December 31, 1919, thus 
covering an entire year and including both the winter and summer 
dietary. 

In this abstract the report for the month of October, 1919, only is 
given, and is designated as table A. 

The results given in table A have been compiled from the steward's 
report, and remarks follow each at the end, and there is a discussion of 
the results, with suggestions as to any possible improvements that might 
be made. 

As in most of these institutions, the steward issues the needed foods 
daily to the different kitchens (at the Penitentiary there are four), an 
accurate account is kept of the daily population, or those who use this 
food, and from this data, at the end of the month, we have what the in- 
mates have lived on for that month. The waste from most of these kitch- 
ens is fed to chickens or hogs, so that the actual loss of food material is 
small. The fruits, vegetables, etc., raised on the institution farm are 
accounted for and issued to the inmates as if purchased at the market 
price. This practice, of course, greatly lowers the actual cost to the 
state of keeping the inmates of these institutions. 

It will be noted that from the steward's report for each month the 
actual weight of the food as given out is stated; then from the standard 
table of food values the protein, fat and carbohydrates is calculated; and 
in the last column the calories or energy value of that amount of food. 
Thus, 24 gallons of apple butter, weighing 240 pounds, yields only 2.88 
pounds of protein and 0.24 pounds of fat; but its value is mostly in the 
140.40 pounds of carbohydrates, and the whole yields 267,600 calories; 
this is its energy value. 

(53) 



54 



A Dietary Study. 



STATE SCHOOL FOR THE BLIND. 
TABLE A.— Dietary for October, 1919. 



Articles op Food. 


Weight, 
pounds. 


Protein, 
pounds. 


Fat, 
pounds. 

10 34 


Carbo- 
hydrates, 
pounds. 


Calories. 




3,447.00 
126.00 

10.00 
400.00 
216.00 

90.00 

65.00 

356.00 

620.00 

60 00 

180 00 

10.00 

24.00 

1,600.00 

159.00 

150.00 

100.00 

4,539.00 

144.00 

30.00 

50.00 

3,005.00 

60.00 

90.00 

752.00 

45.00 

27.00 

100.00 

100.00 

500.00 

120.00 

25.00 

125.00 

820.00 

295 . 00 

40.00 


10.34 
1.13 


342.27 

21.79 

3.00 

19.20 

174.96 

59.31 

61.84 

260.23 

29.76 

12.66 

34.20 

.45 

.62 

1,198.40 


737,658 




42,840 






5,440 




12.00 
11.88 
16.29 
20.80 

34.88 

8.68 

.66 

5.04 

.25 

.21 

179.20 

27.82 


2.00 

3.24 

1.35 

1.23 

32.39 

1.24 

.06 

2.16 

1.85 

.02 

16.00 

29.31 

150 00 

1.90 

181.56 

51.51 

.27 

.15 

3.00 

.12 

.26 

4.51 

.18 

21.27 


64,800 




352,296 




142,740 




159,125 




667,500 




74,772 




24,420 




80,100 




8,810 




1,632 




2,564,800 




170,607 






612,300 




9.20 

149.78 

42.48 

4.02 

.70 

54 09 

2.16 

.26 

10.52 

.22 

1.59 

1.80 

4.70 


75.40 

226.95 

64.38 

22.23 

4.45 

441.73 

5.88 

16.20 

164.68 

5.71 


161,300 




1,425,246 
404,352 




48,720 




9,950 




913,520 




15,060 




30,960 




336,144 




11,520 




92,745 




62.20 

62.50 

500.00 


116,100 




1.00 


126,000 




907,000 




23.40 
5.20 
15 25 


9.00 

.25 

55.00 


79,200 




1 05 

1.37 

660.10 

11.80 

35.20 


12,450 




256,500 




1,189,820 




3.50 
.16 


.55 

.04 


30,385 




64,320 






Totals 


18,510.00 


659.21 


581.76 


4,610.52 


11,941,132 






Amount per day per capita 


4.42 


71 grams 


63 f rams 


499 urnms 


2,853 



The first thing that the inspection of this dietary suggests is its many 
irregularities, as shown by a comparison of the food of different months. 
As will be seen later, this is probably more apparent than real, but it is 
very forcibly brought out in the summaries. For instance, the pounds of 
food per day for each of the pupils seems to be as follows for the twelve 
months: 2.6, 8.88, 2.58, 2.21, 1.76, 4.31, 2.52, 3.53, 2.74, 4.42, 6.64 and 
2.44. That this should be true is absurd, but a glance at the individual 
months shows that 240 pounds of apple butter was dispensed in January 
and none after that; 469 pounds of beef was dispensed in September and 
none in October. The potatoes were stored in October, November and 
February and only small quantities at other times. I am told that these 
irregularities are due to lack of storage facilities, but they certainly 
vitiate any attempt to arrive at the actual monthly dietary, and make it 
necessary to confine our conclusions to the general averages of the year. 

The wide variation as shown for protein in table B is, of course, in- 
correct, as it would not be 126 grams in February and only 42 per capita 
in May. The same remark applies to all the other figures in this table. 
Nor would the calories vary from 1,630 per capita in May to 4,347 in 
February. Although there are very few pupils in the summer months, 



State School for the Blind. 



55 



STATE SCHOOL FOR THE BLIND. 
TABLE B. — Summaries of dietaries for twelve months. — Per capita use of food. 



Dietaries. 



1919 

January 

February 

March 

April 

May 

June 

July 

August 

September. . . . 

October 

November .... 
December. . . . 

Average. . 



Weight 
of food, 
pounds. 



2.06 
8.88 
2.58 
2.21 
1.76 
4.31 
2.52 
3.53 
2.74 
4.42 
6.64 
2.44 



3.67 



Protein, 

grams. 



53 

126 
78 
61 
42 

106 
44 
77 
49 
71 

100 
58 



Fat, 
grams. 



75 
95 
94 
82 
68 
115 
147 
81 
69 
63 
112 
103 



Carbo- 
hydrates, 
grams. 



202 
739 
291 
223 
211 
612 
177 
470 
276 
499 
508 
198 



Calories. 



1,7 2 
4,347 
2,342 
1,892 
1,630 
3,813 
2,214 
2,871 
1,925 
2,853 
3,452 
1,962 



2,( 



Cost 

per day 

per capita. 



SO. 23 
.38 
.27 
.23 
.19 
.40 
.57 
.65 
.24 
.28 
.36 
.27 



SO. 38 



the per capita consumption of food should only be a little higher than 
during the rest of the year. 

In this table, however, appear the average of the different nutrients 
for the entire year. The average age of the girls in this school for 1920 
was 14 1 / l2, and of the boys 13%i. As the teachers and employees were also 
fed from this supply, this would raise the average food requirements 
somewhat. It is evident that the cost per day, as shown in this table, is 
of no value. The average cost, however, for the year of 38 cents per day 
for each of the inmates is perhaps not higher than would be expected con- 
sidering the rapidly mounting cost of living during this year. 

Table C attempts to answer the question, What is the source of the 
energy derived from the food? The averages in the last column are the 
only figures to be considered, and it will be noticed that although bread- 
stuffs furnish the largest part of the energy, on the whole, the amounts 
are fairly distributed between the seven classes. 

How many ounces of each class of food did the inmates use daily? 
(Table D.) Potatoes and milk constitute the largest amount, but these 
both contain large quantities of water, while such foods as sugar contain 
practically no water. Flour is the next staple in quantity, and this con- 
tains less water than does the butter. 

What is the source of the protein (the material that builds up the 
tissues). The following averages for the year were obtained: Vege- 
tables, fresh and dried, 12.64; vegetables, canned, 1.59; cereals, bread- 
stuffs, 26.10; meat, fresh, 17.34; fish and canned meat, 10.96; milk, con- 
densed, fresh, and buttermilk, 24.59; fruits, fresh, dried, canned, 2.72; 
butter, oleo, eggs, cheese, 4.39. Average of protein from animal sources, 
57 per cent; from vegetable sources, 43 per cent. 

RECAPITULATION. 

1. With reference to the quality of the food furnished, it seems to be 
excellent, as is the case with the other institutions studied. Although 
not "extra fancy," it is, as a rule, good, substantial and wholesome. The 
following samples, which it was though might be unsatisfactory, were 
examined at the University Food Laboratory: 



56 



A Dietary Study. 









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State School for the Blind. 57 

A. Vanilla — "Fine Flavoring Extract." This was found to contain 
37 per cent of alcohol, and there was nothing to indicate that it was not 
of good quality. 

B. Tomatoes, complained of as containing some "swells." The sample 
examined was normal in appearance, taste, and color. It contained no 
added water. 

C. Loose muscatel raisins were found to contain living insects and 
to have a musty odor. Stems and disintegrated fruit were present, all 
of which indicated inferiority. 

2. At the end of each monthly table is a summary for that month. 
As previously stated, the method of issuing supplies to the kitchen is 
not satisfactory, and storage facilities should be such that an accurate 
account can be kept of what food is issued and used, at least for the 
month, if not daily. 

3. The wide variation in calories, protein, fat and carbohydrates is 
brought out very clearly in table B. The averages on the lower line 
are the only figures worthy of consideration. It will be noted that if we 
consider the estimate of the interallied Scientific Food Commission 
(1918), that 3,410 calories per day is sufficient for the adult, and that 
growing boys and girls of the average age of these pupils (13 to 14) 
need 83 per cent of the above; that would require 2,830 calories. The 
average for the year was 2,668. This appears to be rather low when we 
consider the fact that the population of the three summer months was 
practically all adults, and these would need more food. On the other 
hand, it was learned that some of the pupils spend the week-end at 
home, which would increase the calorie value for the total population. 

4. The average protein (72 grams), as shown by table B, appears to 
be somewhat low for this class of inmates, 10 per cent of whom were 
adults. 

5. The average cost of living, 38 cents per day per capita, is not higher 
than would be expected when the rapidly increasing cost of food during 
this period is considered. It was higher during the summer months, 
when adults only were fed, than during the rest of the year. 

6. The energy derived from the different classes of foods, as shown by 
table C, is quite well distributed. The quantity of milk used should be 
increased, especially for growing children. This was about a pint per day 
for each of the inmates, but varied greatly during the different months. 
One thousand calories obtained from milk usually cost only half as 
much as the same amount of energy obtained from meat. 

7. The protein from animal sources was 57 per cent of the diet, and 
that from vegetable sources 43 per cent. It is well to increase the 
vegetables in the diet as much as possible. 

8. On account of the proximity of the Kansas City markets, it would 
seem to be possible to substitute fresh fish in season for a part of the 
meats. 



VIII. 

STATE TRAINING SCHOOL, WINFIELD. 

Lawrence, Kan., April 25, 1921. 

In the continuation of the study of the dietaries of the state institu- 
tions under the care of the Board we have taken up the food supply of the 
State Training School at Winfield. As collaborative investigations are 
being made by another department on this institution, we have confined 
our study to the limited period from July 1, 1920, to December 31, 1920, 
without a special study of each month. The entire food supply for this 
half year is therefore considered. This supply, calculated to weight, 
pounds of protein, of fat and of carbohydrates, and in the terms of 
calories, is stated in table A. 

In regard to the weight of different foods as shown by table A, column 
1, the largest quantities used are as follows: 

Weiyht Per cent of 

pounds. water. Calories. 

Fresh milk 236,102 87 74,136,028 

White flour 81.707 12 130,976,321 

Irish potatoes 27,630 18 8,399,520 

Fresh beef 19,716 50 19,321,680 

Tomatoes (canned) 16,697 94 1,719.791 

Corn (canned) 13,696 23 6,094,720 

Tomatoes (fresh) 11.911 94 1,226,833 

Sugar 10,000 10 18,140,000 

Corn (fresh) 9,882 90 1,758,996 

In the first column these foods are arranged in the order of their 
weights; but on account of the vastly different water content, the per 
cent of which is shown in the second column, the arrangement of their 
food value, as shown by the calories in the last column, is very different. 

This table also shows that the per capita amount of protein per day 
is 96.49 grams, which seems to be satisfactory, as it is not very much be- 
low what would be required for adults in good health engaged in ordinary 
work. 

The calories per day per capita, 3,188, is a little less than the average 
amount required for adults ordinarily employed (3,300 to 3,500), but it 
seems to be ample considering the physical condition and exercise of 
those who are fed from this diet. 

The cost per day per capita ($0.29) seems to be very reasonable, con- 
sidering the cost of living during the period studied. 

(58) 



State Training School. 



59 



STATE TRAINING SCHOOL. 
TABLE A.— Dietary frcm July 1, 1920. to December 31, 1020. 



Articles of Food. 



Apples, canned 

Apples, dried 

Apple butter 

Apples, fresh 

Apricots, canned. . . . 

Apricots, dried 

Bacon 

Baking powder 

Beans, Lima 

Beans, Mexican 

Beans, string, canned 

Beans, string 

Beets 

Beans, navy 

Beef, fresh 

Blackberries 

Bread 

Cabbage 

Carrots 

Cantaloupes 

Catsup 

Celery 

Cherries, canned .... 

Cheese 

Chocolate 

Chowchow 

Corn 

Corn, fresh 

Corn meal 

Cucumbers 

Cornstarch 

Crackers, cream 

Crackers, Graham . . . 

Crackers, soda 

Corn flakes 

Cranberries 

Currants 

Candy 

Cabbage 

Chickens, dressed. . . 

Eggs 

Fish 

Figs 

Flour, white 

Flour, Graham 

Gooseberries, canned 

Grapes, canned 

Grapenuts 

Ham 

Hominy 

Kraut 

Liver 

Lemons 

Lemon pudding 

Life of Wheat 

Macaroni 

Mackerel 

Melons, water 

Milk, fresh 

Milk, condensed 

Nuts 

Onions 

Oatmeal 

Oranges 

Oleomargarine 

Oysters, canned 

Peaches, canned 

Peaches, dried 

Peas, canned 

Peas, dried 

Pears, fresh 



Weight, 
pounds. 



1,740 00 

4,950.00 

120 00 

2,220.00 

672.00 

500.00 

458.50 

200.00 

3,580.00 

2,800.00 

4,8.30.00 

2,508.00 

780.00 

6,300.00 

19,716 00 

420.00 

600.00 

4,975.00 

456.00 

720 00 

99.00 

300 00 

240.00 

1,025.00 

12.00 

53.00 

13,696.00 

9,882 00 

505.00 

2,049 00 

1,248.00 

308.00 

352 00 

2,000 00 

72.00 

200.00 

1.00 

370 00 

2,646.00 

122.00 

. 522.00 

540.00 

650.00 

81,707 00 

1,000.00 

128.00 

288.00 

36.00 

644.00 

6,480.00 

360.00 

51.00 

30.00 

25.00 

189 00 

740.00 

60.00 

300.00 

236,102 00 

288.00 

375.00 

475.00 

8,835.00 

370.00 

8,340.00 

105.00 

1,371 00 

3,700.00 

6,816.00 

1,140.00 

45 00 



Protein, 
pounds. 



3.48 
79.20 
1.44 
6.65 
12.76 
23.50 
43.55 



647.98 

613.20 

53.13 

53.92 

10.14 

1,417.50 

2,858.82 

3.36 

55.80 

69.65 

4.10 

2 .16 

1 48 

2.70 

2.64 

295 . 20 

1.54 

.21 

383.48 

118.58 

46.46 

14.34 



29.87 

35.20 

196.00 

3.96 

.80 

.01 



37,04 

16.71 

62.11 

62.64 

27.95 

9,151.18 

133.00 

1.66 

3.74 

4.14 

112.70 

537.84 

6.12 

10.30 

.21 

.82 

20.79 

99.16 

8.34 

.60 

7,791.36 

2.76 

18.37 

6.65 

1,475 44 

2.22 

100 08 

9.24 

9.59 

173.90 

245.37 

280.44 

.22 



Fat, 
pounds. 



13.92 

108.90 

.12 

6.65 

8.73 

5.00 

273.34 



53.70 

36.40 

4.83 

7.70 

.78 

113 40 

3,312.28 

8.82 

7.20 

9.95 

.91 



.19 

30 

.24 

367.97 

5.84 

.05 

164.35 

39.52 

9.59 

4.81 



37.26 

33.08 

182.00 

1.08 

1.20 



5.29 

15.00 

45.54 

89.64 

1.95 

817.07 

22.00 

1 92 

4.60 

.36 

119.14 

38.88 

ISO 

1.58 

.15 

.80 

2.64 

6.66 

12.72 

.30 

9,444.0.8 

2.67 

64.87 

1.42 

644.95 

.37 

6,922.20 

2.52 

1.36 

3.70 

13.63 

11.40 

.18 



Carbo- 
hydrates, 
pounds. 



647.28 
3,271.95 
70.20 
239.75 
327.93 
312.50 



60.00 

2,359.22 

1,822.80 

183.54 

177.19 

60.06 

3,754.80 



236.88 

316.20 

238.80 

33.74 

33.12 

33.12 

7.80 

50.64 

3.07 

3.63 

10.97 

2,602.24 

760.91 

380.77 

62.63 

1,123.20 

214.67 

259.77 

1,462 00 

58.32 

19.80 

.12 

355 . 20 

126.92 



482 30 

61,198.54 

714.00 

24.44 

55.29 

28.44 



5,119.20 

13.68 

1.27 

1 77 

7.05 

144 . 20 

548.34 



8.10 

11,805.10 

3.21 

13.12 

42.27 

5,848.77 

31,49 



4.09 

148.06 

2,312.50 

666. S6 

706.80 

5.71 



Calories. 



1,270 

6,524 

133 

475 

672 

630 

1,190 

108 

5,677 

4,690 

449 

451 

130 

9,853 

19,321 

483 

704 

597 

72 

04 

04 

20 

99 

2,043 

33 

20 

0,094 

1,758 

514 

103 

2,030 

595 

070 

3,750 

117 

42 

000 

317 

91 

310 

479 

934 

130,970 

1,027 

57 

125 

00 

091 

10,419 

45 

27 

4 

18 

.310 

1,201 

07 

17 

74,136 

386 

322 

94 

15,929 



28,439 
35 
290 



4,662,000 

1,710,816 

1,837,680 

11,520 



200 
100 
800 
180 
000 
000 
724 
800 
880 
000 
190 
968 
260 
200 
680 
000 
400 
000 
504 
008 
008 
400 
600 
850 
204 
935 
720 
996 
565 
812 
736 
980 
208 
000 
432 
200 
259 
450 
520 
622 
590 
520 
050 
321 
000 
600 
856 
588 
012 
840 
000 
438 
200 
000 
149 
760 
0«0 
100 
028 
016 
125 
525 
505 



62,5.30 



100 

175 

923 



60 A Dietary Study. 

TABLE A.— Dietary from July 1, 1920, to December 31, 1920— Concluded. 



Articles of Food. 



Pears, canned 

Pears, dried 

Pineapple, canned 

Pickles 

Plums, canned 

Pork, fresh 

Pork loins 

Potatoes, Irish 

Potatoes, sweet 

Prunes 

Pumpkin, canned 

Rhubarb 

Raspberries, canned 

Raisins 

Rice 

Salt pork 

Salmon 

Sausage, pork 

Sardines 

Sugar 

Shredded wheat 

Shortening 

Sirup 

Tapioca 

Tomatoes, fresh 

Turnips 

Tomatoes, canned 

Water melons 

Yeast 

Totals 

Average for each of six months 

Amount per day per capita 

Cost per day per capita, $0.29. 
Cost per thousand calories, $0,091 



Weight, 
pounds. 



378 00 

390.00 

504 00 

450 00 

462 00 

1,094.00 

391.00 

27,630 00 

5,624.00 

8,123.00 

816 00 

158.00 

222 00 

500.00 

5,200 00 

218.00 

384.00 

403.00 

69.00 

10,000 00 

81.00 

6,000.00 

4,880.00 

20.00 

11,911 00 

4,345.00 

16,697.00 

7,106 00 

88 00 



,141 50 



111,523.68 
4.87 



Protein, 
pounds. 



1.13 

10.92 

2.01 

2.25 

2.31 

82.05 

60 60 

497.34 

78.73 

146 21 

6.52 

63 

3 77 

11 50 

416.00 

12.86 

14.88 

52.39 

16.35 



.80 



.08 
107.19 
39 10 
200.36 
14.21 
10.29 



29,304 98 



4,884.16 
96.49 grams 



Fat, 
pounds. 



1 13 

21.06 

3.50 

1.35 

.46 

599.51 

56 69 

27.63 

33.74 



1 63 

63 

2.22 

15.00 

15 60 

171 78 

28.80 

177.32 

8.34 



1.45 
6,000.00 



.02 

47.63 
4.34 

33 39 

7.10 

.35 



30,384 17 



5,064 03 
100.11 gms. 



Carbo- 
hydrates, 
pounds. 



68.04 
284 31 
183.45 

12.15 
103 . 02 



4,061.61 

1,231.65 

5,052.50 

54.67 

3 47 

27.97 

342.50 

4,108.00 



10,000 00 
60.91 



3,928.40 
17.60 
464.52 
247.66 
667 88 
191.86 
18.48 



142,481 49 



23,746.91 
470.21 gms. 



Calories. 



130,032 

637,650 

359,784 

31,500 

198,660 

2,685,770 

341,343 

8,399,520 

2,513,928 

9,510,803 

122,400 

9,796 

66,600 

703,500 

8,273,200 

749,830 

253,440 

826,956 

63,756 

18,140,000 

134,217 

24,492,000 

7,080,880 

32, 160 

1,226,833 

538,780 

1,719,791 

405,042 

53,680 



437,589,642 



72,931,607 
3,188 



STATE TRAINING SCHOOL. 
TABLE B. — Comparison of the per capita use of some of the important staples. 

Staples. Ounces. 

Flour, white 9 . 44 

Corn meal . 06 

Potatoes, Irish and sweet 3 . 84 

Beans, dried 1 . 44 

Sugar and sirup 1 . 44 

Beef 3.24 

Pork, fresh and cured . 32 

Lard 0.64 

Sausage . 04 

Butterine . 96 

Milk 27 . 52 

Fruit, dried 3.24 

Fish, fresh and canned 0.14 

Bread 0.06 

Table B is interesting in that it shows what the staple foods were. 
Bread, potatoes, beef and dried fruits made up most of the diet. There 
was a generous use of milk — nearly a quart per capita per day. This is to 
be greatly commended. Only a detailed study of the daily menu will 
show how well the nutrients mentioned in this table are utilized for the 
best care of the inmates. 



State Training School. 61 



STATE TRAINING SCHOOL. 

Table C. — Classification of groups of foods — Per cent of calories of total calories. 
Classes of foods. Per cent. 

Breadstuffs 36.02 

Vegetables . . 13 . 48 

Fruits 6.91 

Sugar, sirup 5.91 

Butterine, lard 12.09 

Milk, cheese, eggs 17.56 

Meats, fish 8.43 

The classification in table C tells the source of the energy derived 
from the food. It will be noticed that breadstuffs furnish more than one- 
third; next comes milk, cheese and eggs; then vegetables, followed closely 
by butterine and lard. The aim should be made to increase as much as 
possible the use of fruits and vegetables, for in an institution of this kind 
a stimulating diet is not needed. 

STATE TRAINING SCHOOL. 

TABLE D. — Per cent of protein compared with total protein from each of the following 

classes of foods. 

Total protein, 

Foods. pounds. Per cent. 

Vegetables, fresh and dried 4,000 .92 13 . 65 

Vegetables, canned 1,435 . 07 4.89 

Fish 171.45 .58 

Cereals 1,976 . 59 6 . 74 

Breadstuffs 9,710.58 33.13 

Meat, fresh 3,028.48 10.33 

Meat, canned and salt 221.50 0.75 

Milk 7,818.96 26.68 

Fruits 568.06 1.93 

Cheese and eggs 357.31 1.22 

Butterine 100 .08 0.34 

Average per cent protein: Vegetable sources, 60.10 per cent; animal sources, 39.90 
per cent. Cost per 1,000 calories, $0,091. 

Table D shows where the protein comes from. Here again the bread- 
stuffs have the lead, followed by milk, vegetables and meat. The total 
protein from vegetable sources, 60.34, is large, and accentuates again 
the fact that large quantities of vegetables are used, which is to the ad- 
vantage of those using the food. 

RECAPITULATION. 

1. The study of the dietary for this half year has been taken up to 
determine the quantity of food used, and whether the nutrient material 
was so distributed as to be sufficient and satisfactory for the inmates, 
in order that their physical health and vigor may be conserved. 

2. Another object was to determine the relative cost of the different 
food ingredients, and the comparison of this with that dispensed at other 
state institutions. 

3. Both the total amount of food used per day per capita, as indicated 
by the calories, and the proportion of protein and of fat are satisfactory. 

4. The cost of 29 cents is very moderate, considering the high cost of 
food on the market. 

5. The large amount of milk used is to be commended. Not only is it 
valuable for growth and nourishment, but its cost is not so much higher 
than other foods as is often supposed. 



62 A Dietary Study. 

6. This analysis of the diet shows a large quantity of vegetables used, 
which must be of great advantage, not only on account of the variety 
furnished, but because a vegetable diet will improve the health of the in- 
mates. This is also brought out in table D. 

7. The cost of 1,000 calories is an index of what the energy used, re- 
gardless of its source, actually costs. The figure, 91 mills, is very mod- 
erate, considering the cost of living. 

8. The excellent report from the steward's office, furnished by Supt. 
W. W. Cooke, aided greatly in making this study of the dietary. 



IX. 

STATE SCHOOL FOR THE DEAF, OLATHE. 

(Abstract of Report.) 

Lawrence, Kan., May 26, 1921. 

Herewith is presented a report on the dietary of the State School for 
the Deaf at Olathe. 

At my request, the superintendent, Mr. Elwood A. Stevenson, has sent 
me a list of the foods used for the months of September, October, No- 
vember and December, 1920. The month of December only is here given 
as table A. A discussion of each table follows. 

As evidence of the variety of the food used, it is noted that more than 
75 different articles appear in table 'A. 

The advantage of a dietary covering a long period is shown in the 
irregularity of the following four months' table (table B). There is 
evidently some flour carried over from one month's account to the next. 
The same thing is true of the potatoes, beef and pork. 

There is an important increase in the milk used after September. The 
average of these months might be computed, but it is not as definite a 
figure as if a longer period were studied. Considering the single month 
of December there was issued 6.11 ounces of fruit, fresh, canned and 
dried, daily per capita — an abundant quantity, which, while adding con- 
siderably to the expense, would also tend to improve the physical health 
of the inmates. 

(63) 



64 



A Dietary Study. 



STATE SCHOOL FOR THE DEAF. 
TABLE A.— Dietary for Decenber, 1920. 



Articles of Food. 


i 
Weight, 
pounds. 


Protein, 
pounds. 


Fat, 
pounds. 


Carbo- 
hydrates, 
pounds. 


Calories. 




216.00 

250.00 

180.00 

336.00 

25.00 

834.00 

10.00 

8.00 

187.00 

200.00 

90.00 

1,466.00 

4.00 

180.00 

111.50 

8.00 

600.00 

215.00 

37.00 

250.00 

48.00 

36.00 

192.00 

104.00 

106 00 

4.00 

18.00 

25.00i 

48 00 

224.00 

190.00 

8.00 

2.00 

192.00 

25.00 

.75 

32.00 

48.00 

18.00 

64.00 

333.00 

60.00 

24.00 

3.50 

63.00 

10,344.50 

20.00 

90.00 

115.00 

15.00 

90 00 

:o.o 

90.00 

192.00 

50 00 

126 00 

343.50 

1,920.00 

250.00 

75.00 

25.00 

56.00 

25 00 

120.00 

36.00 

32 00 

200.00 

1,200.00 

120.00 

5.00 

236.00 

3,500 00 

8.00 


0.43 
.75 
2.16 
3.02 
1.17 
79.23 


1.72 
.75 
.18 


80.35 
27.00 
105.30 
58.12 
15.62 


157,680 




52,800 




200, 700 




114,240 




.25 
495.39 


31,500 




2,165,898 


R k' nowder 


3.00 

1.14 

123.23 

119.20 

3.42 


5,440 




.06 

33.84 

45.00 

.99 

212.57 

1 05 

1.44 

20.29 

.08 

7.20 

3.01 


.03 
2.80 
3.60 

.09 

246.26 

.27 

3.78 

21.96 

6.80 

498.00 

.43 


2,320 




296,582 




312,800 




8,370 


,/' r r ' V 


1,436,680 


R f 1 prl 




3,040 




101.52 


102,320 




14,941 






27,904 






2,146,000 




10.32 
35.52 
18.50 
5.90 
.93 
40.50 
.31 


25,800 




66,045 




2.25 

.72 

.32 

2.22 

29^95 

14.52 

.02 

.99 

2.30 


.50 
.96 
.03 
.18 
37.32 
13.03 
.06 
.27 
.47 


39,750 




12,720 




2,448 




79,680 




207,376 




79,606 


Citron 


3.12 

14.58 

18.85 

43.20 

42.56 

138.80 

5.93 

1.41 


5,948 




29,358 




40,325 




78,336 




6.27 

18.60 

.19 

.03 

22.84 

3.32 

.68 

.41 

.28 

2.07 

.76 

58.27 

.72 

.16 

.03 

6.93 

341.36 

.98 

15.03 

.69 

1.32 

.63 

2 35 
.27 

6!0 

14.65 

1.26 

25.76 

34.56 

3.50 

1.35 

.82 

1.28 

2.00 

23 40 

3 52 
7.58 

26.00 


2.68 

17.20 

.13 

.05 

17.85 

.55 


99,680 




356,250 




11,672 




2,832 


., 


114,240 




17.85 


40,675 




1,246 




.48 
.04 
.18 
.06 
61.60 


6.11 
4.08 
15.88 
37.44 


16,400 




8,112 




30,294 




71,360 




367,309 




35.88 

1.41 

.87 

48 06 

517.22 

.70 

59.58 

9.77 

.58 

9.72 

31.25 

16.20 

18.81 

8.55 

25.32 


68,100 




.11 


3,360 




252 




.88 

413.78 

3.46 

6.57 

.11 

.36 

.09 

.5 i 

.27 

.36 

23.25 


106,155 




3,248,173 




17,186 




162,270 




19,435 
5,025 




19,170 




64,500 




30,960 




48,192 




137,050 




49,770 


,, , ;. , 


188.23 
1.92 
1.50 


843,292 




282.24 
54.75 
46 65 
7.05 
38.36 
19.75 


583,680 




111,750 




87,075 




.80 
1.68 
.17 
9.00 
3.26 
3.87 
88.00 


18,000 




78,792 




39,775 




79,200 




26.30 


67,500 




29,568 




2.20 

1,200 00 

96.60 

4.40 

9.44 
2,621.50 

1.68 


410,400 




2,176,800 


q^ ' g 






174,120 


T inpfl 


.20 

2.80 

392.00 

.93 




8,040 




.44 

35.00 

.03 


24,308 




5,610,500 




4,880 




26,409.75 


1,498.28 


2,219.59 


6,294.53 


23,193,949 


Amount per day per capita 


s.67 


93 grams 


139 grams 


333 grams 


3,225 



State School for the Deaf. 



65 



STATE SCHOOL FOR THE DEAF. 
TABLE B. — Per capita use of some of the important staples. 



Staples. 


September, 
ounces. 


October, 
ounces. 


November, 
ounces. 


December, 

ounces. 




7.15 

.04 

8.92 

.70 

3 05 

2.84 

2.54 

.72 

.35 

1.50 

15.56 

.22 

43 


8.89 


9.26 

.04 

12.59 

.44 

2.52 

3.28 

2.04 

.91 

.44 

1.40 

30.12 


7.84 




.04 




2.88 

1.13 

3.10 

4.80 

3.07 

.88 

.44 

1.36 

29.52 

.01 

.49 


4.81 




.84 




2.88 




3.26 




3.36 








.68 




1.34 




23.00 




.48 


Fish, canned 


.24 


.36 



STATE SCHOOL FOR THE DEAF. 
TABLE C. — Per capita use of food for four months. 



Month, 1920. 


Weight 
of food, 
pounds. 


Protein, 

grams. 


Fat, 
grams. 


Carbo- 
hydrates, 
grams. 


Calories. 




3.65 
4.55 
5.22 
3.67 


78 
111 
110 

93 


Ill 
167 
159 
139 


393 
459 
492 
333 


3,192 


October 

November 

December 


3,814 
3,865 
3,225 



STATE SCHOOL FOR THE DEAF. 
TABLE D. — Total attendance, population, cost, and cost per day. 



Period of Study, 1920. 


Total 
popula- 
tion. 


Total 
attend- 
ance. 


Total 

cost 

per month. 


Cost 

per day 

per capita. 




227 
230 
230 

230 


6,810 
7,190 
6,900 
7.190 


$2,348.49 
3,061.11 
2,778.36 
2,428.86 


80.345 




.425 




.402 


December 


.335 



Table C shows that the average protein (98 grams per day) is suffi- 
cient for inmates of this class, while the 3,524 calories afforded by the 
food is certainly abundant and might be slightly decreased without loss 
to physical well-being. 

Table D refers to the cost per day, and is not high considering the 
high market price during this period. 

Table E shows where the energy of the food comes from. Breadstuffs 
furnish more than a quarter, and the remainder is distributed between 
the other food products. Butter and its substitutes seem to furnish a 
large amount of energy, but it should be remembered that the fuel value 
of fats is very high. Fruits, although abundant, do not furnish much 
energy, as they contain so much water. Fruits canned in sirup, however, 
afford considerable nutriment on account of the high fuel value of sugar. 



5 — Dietary — 575 



66 



A Dietary Study. 



STATE SCHOOL FOR THE DEAF. 
TABLE E.— Classification of groups of food.— Per cent of calories of total calories in the groups given. 



Classes of Foods. 


September, 
per cent. 


October, 
per cent. 


November, 
per cent. 


December, 
per cent. 




25.37 
10 65 
6.69 
10.60 
18.74 
10.07 
17.34 


24.44 
6.40 
6.62 
9 . 22 
13.61 
16.19 
19.84 


29.14 
10.24 
6.96 
7.46 
13.98 
16.54 
16.19 


28.31 




7.34 




9.24 




10.13 




8.94 




15.39 




21.43 



TABLE F— Showing the tots 



STATE SCHOOL FOR THE DEAF. 

number ot pounds and the per cent of protein obtained from each of the 
following sources. 



Source. 


September. 


October. 


November. 


December. 


Pounds. 


Per cent. 


Pounds. 


Per cent. 


Pounds. 


Per cent. 


Pounds. 


Per cent. 


Vegetables, fresh and dried 


145.69 
42.23 
38.56 

384.33 

177.69 
90.27 

218.79 
31.36 
43.15 


12.42 
3.60 
3.29 

32.79 

15.16 
7.70 

18.66 
2.67 
3.68 


141.63 
28.16 
34 . 00 
521.49 
314.21 
205 85 
437.86 
23.62 
54.47 


7.99 

1.59 

1 92 

29.44 

17.74 

11.62 

24.72 

1.33 

3.07 


158.83 

23.26 

20.60 

520.83 

321.85 

118.87 

428.88 

24.79 

61.34 


9.45 

1.38 

1.22 

31.02 

19 . 15 

7.08 

25.54 

1.47 

3.65 


122.51 

32.33 

32.30 

448.71 

252.85 

185.52 

341.36 

22.63 

60.07 


8.17 
2.15 


Fish 


2.15 




29.95 




16.87 




12.35 


Milk 


22.79 


Fruit, fresh, canned, dried 

Butter, cheese, eg*s, butterine. . . 


1.51 
4.01 



Total calories for four months 99,028,235 

Total attendance for four months 28,090 

Total cost for four months $10,616.82 

Cost per thousand calories $0 . 107 

Average per cent of proteins from animal sources 56% 

Average per cent of proteins from vegetable sources 44% 

Finally, table F tells where the protein comes from. About one-third 
comes from cereals and breadstuffs. Meat, milk and eggs furnish nearly 
half the protein. 

A study of the sources of the protein shows that 56 per cent is from 
animal and 44 per cent from vegetable proteins. Ordinarily we should 
say that it would be more satisfactory if there were more protein obtained 
from vegetable sources than from animal. In this case, however, the high 
animal protein is probably due to the large amount of milk, and it is of 
great advantage to the inmates to be able to have so much milk. A con- 
venient method for comparing the cost of different dietaries is by com- 
paring the cost per thousand calories, and 10.7 cents per thousand is not 
excessive. 

RECAPITULATION. 

1. There seems to be more difficulty in the smaller institutions to 
check up the actual food used per month or per day than in the larger 
ones, so this dietary is not as satisfactory as one covering six months or 
an entire year. 

2. The protein used in this institution appears to be sufficient for this 
class of inmates. 



State School for the Deaf. 67 

3. The energy as shown by the 3,524 calories per day per capita is 
possibly somewhat in excess of the needs of persons not engaged in active 
physical work. 

4. The cost of the food is not excessive. 

5. The large amount of milk used — nearly a quart in October and 
November — is very satisfactory. It will add little to the expense and 
much to the health to keep the consumption of milk as high as possible. 
In November more calories were afforded by the milk than by any other 
product except wheat flour. 

6. In general this dietary shows the use of abundant food, fairly well 
distributed as to materials. It is, of course, important that the daily 
menu be so varied that it is agreeable to the taste in order to keep up the 
appetite, and that it affords a well-balanced ration. Fresh vegetables and 
fruits should be used abundantly when they can be procured. It is ad- 
visable to keep the meat consumption low. 

Note. — A partial study of the dietary at the State Orphans' Home in Atchison was 
also made, but the methods of issuing the provisions to the kitchens made it difficult to 
arrive at reliable conclusions in regard to the daily use of food, so that a further study 
was deemed advisable before making a final report. 



68 



A Dietary Study. 



COMPARISON OF THE DIETARIES OF NINE KANSAS 
INSTITUTIONS. 

1. These dietaries cover different periods, from July, 1917, to De- 
cember, 1920. 

2. The character of the inmates is entirely different in the different in- 
stitutions. 

3. The three hospitals, that of Topeka, Osawatomie and Parsons 
(which is especially for epileptics), may be compared in some respects. 
It is noticed that the average protein used is quite similar in the Topeka 
and Osawatomie institutions, viz., 83-87. The Parsons hospital is higher 
(101), and very reasonably so. There happens to be a remarkable agree- 
ment between the calories used at the two hospitals, viz., 2,911-2,927, 
while the Parsons institution is higher, as it should be. 

4. The high energy value of the food used at Lansing has already been 
referred to, and is probably higher than necessary. Comparing this, 
however, with some southern prisons, it is noticed that the calorie value 
of the food in 1915 in the Texas prison farms was 5,429 and the Louisiana 
farms 4,196. In the South the staple foods are bacon, beans, corn, flour, 
molasses, sugar and rice. 

5. Comparing the Industrial School for Girls at Beloit with the In- 
dustrial School for Boys at Hutchinson, as these two institutions are 
somewhat alike, it will be noticed that the boys have a somewhat higher 
protein diet of the two institutions, but if we allow the girls 83 per cent 
of the amount given the boys (a proportion that is recommended by many 
authorities), the amounts furnished at the two institutions agree very 
satisfactorily. Recent investigation by Doctor Gephart and others have 
shown that the amount of food utilized by the growing boy is entirely be- 
yond beliefv 

COMPARISON OF INSTITUTIONS. 
TABLE I. — Comparison of the per day per capita use of some of the important staples at nine state institutions. 



Institutions. 



Penitentiary, Lansing 

Industrial School, Hutchinson 

Hospital, Osawatomie 

Industrial School, Beloit 

Hospital, Topeka 

Hospital, Parsons 

School for Blind, Kansas City 

Training School, Winfield 

School for Deaf, Olathe 



Flour, 
oz. 



11.84 
14.83 
8.96 
6.08 
8.04 
7.28 
5.12 
9 44 
8.28 



Pota- 
toes, 
oz. 



17.13 

16.23 
8.71 

11.92 
7.43 
8.57 

16.06 
3 84 
7.30 



Sugars, 



3.48 
2.21 
1.38 
1.75 

1 44 
1.89 
2.98 

1 44 

2 89 



Beef, 



oz. 



9.76 
5.49 
4 33 
1.91 
5.35 
4.43 
2.66 
3.24 
3.54 



Milk, 



11.88 
10.19 
12.93 
31.22 
12.24 
26.34 
16.49 
27.52 
24 55 



Butter 
and oleo, 



oz. 



.76 

.62 

1.03 

1 34 

.72 

.80 

.90 

.96 

1.40 



Pork, 



3.79 

1.89 

1.17 

.67 

.66 

.25 

1.07 

.32 

2.75 



Sau- 



4.03 

.89 
.29 
.00 

.11 
.23 
.04 



A Dietary Study. 



69 



COMPARISON OF INSTITUTIONS. 
TABLE II. — Per capita comparison of the average dietaries of nine state institutions. 



Institutions. 


Weight 
of food, 
pounds. 


Protein, 
grams. 


Fat, 
grams. 


Carbo- 
hydrates, 
grams. 


Calories. 


Cost. 


Cost per 

1,000 
calorics. 


Penitentiary, Lansing, 

July, 1917. to January, 1918 


5.93 


147 


223 


673 


5,389 


80.395 


$0,074 


Industrial School, Hutchinson, 

July, 1917, to March, 1918 


4.49 


122 


108 


639 


4,032 


.270 


.068 


Hospital, Osawatomie, 

July, 1917, to May, 1918 


3.27 


83 


102 


412 


2,911 


.219 


.076 


Industrial School, Beloit, 

September, 1917, to September, 1918. 


4.58 


91 


106 


430 


3,113 


.175 


.058 


Hospital, Topeka, 

October, 1917, to October, 1918 


3.40 


87 


96 


418 


2,927 


.236 


.081 


Hospital, Parsons, 

October, 1918, to October, 1919 


4.70 


101 


109 


481 


3.355 


.330 


.099 


Blind, Kansas City, 

January, 1919, to January, 1920. . . . 


3.67 


72 


92 


366 


2,668 


.380 


.115 


Training School, Winfield, 

July, 1920, to January, 1921 


4.87 


96 


100 


470 


3,188 


.290 


.091 


Deaf, Olathe, 

September, 1920, to January, 1921 . . 


4.27 


98 


144 


419 


3,524 


.377 


.107 



6. There are so many other items that have to be considered under the 
head of cost, that comparisons are difficult. Referring, however, to table 
II, a comparison of state institutions, the United States Department of 
Labor, Bureau of Labor Statistics, reports the following index numbers 
for retail prices of the principal articles of food in the United States. 
Starting with 100 as the average for 1913, the figures are as follows: 



1913 


100 


1917 


146 


1914 


102 


1918 


168 


1915 


101 


1919 


186 


1916 


114 


1920 


203 



This shows a gradual rise in cost from 1917 to 1921, the period of the 
study. Applying this to the cost for 1,000 calories, the food at Lansing 
which cost .074 cents in 1917 should cost .103 cents in 1920. This in 
general agrees with the added cost in the later years. 

7. It is hoped that a comparison of the dietaries of the institutions 
may be of value to the superintendents, and may help them to supply still 
more fully at each institution just the right proportions of the different 
foods adapted to the health and well-being of the inmates. It is only 
by mutual cooperation that we can hope to improve the service. 

8. We fully realize that even with sufficient wholesome food purchased 
by your Board of Administration, unless the greatest care is taken in the 
menu for each day, and even for the individual meals, the best results 
cannot be attained. To serve only starchy food for one meal and 
an overbalanced protein menu for the next will not satisfactorily nourish 
the body. 



70 A Dietary Study. 

9. The place and manner in which the food is served have much to 
do with stimulating the appetite and aiding digestion. A damp, poorly 
lighted basement should never be used as a dining room. Circumstances 
have made this necessary in some instances, but clean, well-lighted dining 
rooms should be provided. 

10. My thanks are especially due to Miss Harriett M. Stevenson, a 
graduate of the department of home economics of the University of 
Kansas, for her very efficient service in working out the details of this 
work. The cheerful assistance offered by the superintendents of the 
various institutions in furnishing the data for this study is also thank- 
fully acknowledged. Respectfully submitted, 

E. H. S. BAILEY. 



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